Provider Demographics
NPI:1124687298
Name:ANGEL HANDS CARE LLC
Entity type:Organization
Organization Name:ANGEL HANDS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-410-5836
Mailing Address - Street 1:PO BOX 6038
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-3938
Mailing Address - Country:US
Mailing Address - Phone:601-410-5836
Mailing Address - Fax:
Practice Address - Street 1:8300 FM 1960 RD W STE 450
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5699
Practice Address - Country:US
Practice Address - Phone:601-410-5836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health