Provider Demographics
NPI:1861707465
Name:ANGELS OF LIFE MEDICAL TEAM & CENTER
Entity type:Organization
Organization Name:ANGELS OF LIFE MEDICAL TEAM & CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DECARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-351-1083
Mailing Address - Street 1:166 BRIGHTON ST
Mailing Address - Street 2:
Mailing Address - City:EAST PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15112-1302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:166 BRIGHTON ST
Practice Address - Street 2:
Practice Address - City:EAST PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15112-1302
Practice Address - Country:US
Practice Address - Phone:412-351-1083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3969620251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health