Provider Demographics
NPI:1841696648
Name:DEANDRA'S ANGELS HOME CARE
Entity type:Organization
Organization Name:DEANDRA'S ANGELS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANDRA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:FURLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-374-8407
Mailing Address - Street 1:1985 LINDSAY LN
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-4353
Mailing Address - Country:US
Mailing Address - Phone:314-374-8407
Mailing Address - Fax:
Practice Address - Street 1:1985 LINDSAY LANE
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031
Practice Address - Country:US
Practice Address - Phone:314-374-8407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health