Provider Demographics
NPI:1306606025
Name:ANGEL HANDS HOME CARE
Entity type:Organization
Organization Name:ANGEL HANDS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATEZEON
Authorized Official - Middle Name:HUMPHREY
Authorized Official - Last Name:BALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-695-9145
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39121-0608
Mailing Address - Country:US
Mailing Address - Phone:215-695-9145
Mailing Address - Fax:
Practice Address - Street 1:700 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-4027
Practice Address - Country:US
Practice Address - Phone:769-204-3699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health