Provider Demographics
NPI:1861780009
Name:CIRCLE OF ANGELS HOME HEALTH CARE
Entity type:Organization
Organization Name:CIRCLE OF ANGELS HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:KENYATTA
Authorized Official - Last Name:TENNIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-217-0933
Mailing Address - Street 1:3005 VILLAGE PARK DR
Mailing Address - Street 2:SUITE 204B
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7993
Mailing Address - Country:US
Mailing Address - Phone:919-217-0933
Mailing Address - Fax:919-217-0932
Practice Address - Street 1:2375 E MAIN ST STE A302
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1432
Practice Address - Country:US
Practice Address - Phone:864-579-3346
Practice Address - Fax:919-217-0932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care