Provider Demographics
NPI:1124352216
Name:ANGELS ABOVE....A SENIOR CONCIERGE SERVICE
Entity type:Organization
Organization Name:ANGELS ABOVE....A SENIOR CONCIERGE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOMACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-219-4111
Mailing Address - Street 1:11220 W FLORISSANT AVE # 192
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-6741
Mailing Address - Country:US
Mailing Address - Phone:314-219-4111
Mailing Address - Fax:314-529-3428
Practice Address - Street 1:11220 W FLORISSANT AVE # 192
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-6741
Practice Address - Country:US
Practice Address - Phone:314-219-4111
Practice Address - Fax:314-529-3428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care