Provider Demographics
NPI:1952012080
Name:REACH ANGELS AGENCY LLC
Entity Type:Organization
Organization Name:REACH ANGELS AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FANTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-462-5415
Mailing Address - Street 1:1055 HOWELL MILL RD NW FL 8
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-5557
Mailing Address - Country:US
Mailing Address - Phone:770-462-5415
Mailing Address - Fax:
Practice Address - Street 1:1055 HOWELL MILL RD NW FL 8
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-5557
Practice Address - Country:US
Practice Address - Phone:770-462-5415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health