Provider Demographics
NPI:1538591771
Name:ANGELS OF LOVE HOME CARE
Entity type:Organization
Organization Name:ANGELS OF LOVE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED MED TECH
Authorized Official - Phone:267-266-3276
Mailing Address - Street 1:9803 HALDEMAN AVE APT B103
Mailing Address - Street 2:9803 HALDEMAN AVE SUITE B-103
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-2215
Mailing Address - Country:US
Mailing Address - Phone:267-266-3276
Mailing Address - Fax:
Practice Address - Street 1:9803 HALDAMEN AVE APT B-103
Practice Address - Street 2:9803 HALDAMEN AVE APT B-103
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115
Practice Address - Country:US
Practice Address - Phone:267-266-3276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health