Provider Demographics
NPI:1063835080
Name:ANGELIC HOME AND HEALTH CARE SERVICES
Entity type:Organization
Organization Name:ANGELIC HOME AND HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:862-703-1786
Mailing Address - Street 1:523 PROSPECT ST
Mailing Address - Street 2:8
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-3230
Mailing Address - Country:US
Mailing Address - Phone:862-703-1786
Mailing Address - Fax:
Practice Address - Street 1:523 PROSPECT ST
Practice Address - Street 2:8
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-3230
Practice Address - Country:US
Practice Address - Phone:862-703-1786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care