Provider Demographics
NPI:1285948299
Name:EARTH ANGELS NC
Entity type:Organization
Organization Name:EARTH ANGELS NC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-625-6135
Mailing Address - Street 1:PO BOX 5672
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27204-5672
Mailing Address - Country:US
Mailing Address - Phone:336-625-6135
Mailing Address - Fax:
Practice Address - Street 1:817 S FAYETTEVILLE ST STE C
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6489
Practice Address - Country:US
Practice Address - Phone:336-625-6135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4116253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care