Provider Demographics
NPI:1144332347
Name:ANGEL WINGS HOME HEALTH CARE AGENCY
Entity type:Organization
Organization Name:ANGEL WINGS HOME HEALTH CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-495-2937
Mailing Address - Street 1:7303 LAS BRISAS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-4325
Mailing Address - Country:US
Mailing Address - Phone:281-495-2937
Mailing Address - Fax:281-879-7937
Practice Address - Street 1:7303 LAS BRISAS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-4325
Practice Address - Country:US
Practice Address - Phone:281-495-2937
Practice Address - Fax:281-879-7937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health