Provider Demographics
NPI:1841970803
Name:ANGELIC SERVICES, INC.
Entity type:Organization
Organization Name:ANGELIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, CRCFA
Authorized Official - Phone:864-205-9481
Mailing Address - Street 1:140 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29340-4726
Mailing Address - Country:US
Mailing Address - Phone:864-489-1288
Mailing Address - Fax:864-480-7818
Practice Address - Street 1:140 4TH AVE
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-4726
Practice Address - Country:US
Practice Address - Phone:864-489-1288
Practice Address - Fax:864-480-7818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX1385Medicaid