Provider Demographics
NPI:1083018568
Name:ANGELIC SERVICES, LLC
Entity type:Organization
Organization Name:ANGELIC SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CRCFA, LPN
Authorized Official - Phone:864-205-9481
Mailing Address - Street 1:206 W MEADOW ST
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29341-2350
Mailing Address - Country:US
Mailing Address - Phone:864-205-9481
Mailing Address - Fax:
Practice Address - Street 1:206 W MEADOW ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29341-2350
Practice Address - Country:US
Practice Address - Phone:864-205-9481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANGELIC SERVICES, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care