Provider Demographics
NPI:1124490032
Name:HEALS ON WHEELS
Entity type:Organization
Organization Name:HEALS ON WHEELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:LUCIA
Authorized Official - Last Name:DAHMS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:916-204-3654
Mailing Address - Street 1:224 E ARIZONA CIR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AZ
Mailing Address - Zip Code:85132-9705
Mailing Address - Country:US
Mailing Address - Phone:916-204-3654
Mailing Address - Fax:
Practice Address - Street 1:224 E ARIZONA CIR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AZ
Practice Address - Zip Code:85132-9705
Practice Address - Country:US
Practice Address - Phone:916-204-3654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7565251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health