Provider Demographics
NPI:1982901369
Name:ANGEL CARE
Entity Type:Organization
Organization Name:ANGEL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:LEVETTE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-859-8828
Mailing Address - Street 1:6551 STAGE OAKS DR
Mailing Address - Street 2:3B
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3895
Mailing Address - Country:US
Mailing Address - Phone:901-389-0319
Mailing Address - Fax:
Practice Address - Street 1:6551 STAGE OAKS DR
Practice Address - Street 2:3B
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3895
Practice Address - Country:US
Practice Address - Phone:901-389-0319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-20
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN111000798251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health