Provider Demographics
NPI:1194558379
Name:CASSELL, ANGEL G (HOME CARE AID)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:G
Last Name:CASSELL
Suffix:
Gender:F
Credentials:HOME CARE AID
Other - Prefix:
Other - First Name:ANGEL
Other - Middle Name:G
Other - Last Name:CASSELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:191 REUBEN RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-7830
Mailing Address - Country:US
Mailing Address - Phone:336-635-8110
Mailing Address - Fax:
Practice Address - Street 1:191 REUBEN RD
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-7830
Practice Address - Country:US
Practice Address - Phone:336-635-8110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion