Provider Demographics
NPI:1932531613
Name:ANGEL STAR HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:ANGEL STAR HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BODLEY
Authorized Official - Middle Name:H
Authorized Official - Last Name:XU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-379-6807
Mailing Address - Street 1:1133 S EDWIN C MOSES BLVD
Mailing Address - Street 2:SUITE 380
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-4094
Mailing Address - Country:US
Mailing Address - Phone:513-379-6807
Mailing Address - Fax:937-567-8881
Practice Address - Street 1:1133 S EDWIN C MOSES BLVD
Practice Address - Street 2:SUITE 380
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-4094
Practice Address - Country:US
Practice Address - Phone:513-379-6807
Practice Address - Fax:937-567-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health