Provider Demographics
NPI:1093689010
Name:ANGEL FAMILY HOME CARE
Entity type:Organization
Organization Name:ANGEL FAMILY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAITRAM
Authorized Official - Middle Name:THI
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:770-680-9967
Mailing Address - Street 1:4405 INTERNATIONAL BLVD STE C101
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-3013
Mailing Address - Country:US
Mailing Address - Phone:470-448-4714
Mailing Address - Fax:678-840-3574
Practice Address - Street 1:4405 INTERNATIONAL BLVD STE C101
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-3013
Practice Address - Country:US
Practice Address - Phone:470-448-4714
Practice Address - Fax:678-840-3574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care