Provider Demographics
NPI:1902646565
Name:AFFECTIONATE ANGELS HEALTHCARE INC
Entity type:Organization
Organization Name:AFFECTIONATE ANGELS HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERIFF
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-208-3004
Mailing Address - Street 1:1636 GRASSY HILL CT
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-4302
Mailing Address - Country:US
Mailing Address - Phone:774-208-3004
Mailing Address - Fax:
Practice Address - Street 1:1636 GRASSY HILL CT
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017-4302
Practice Address - Country:US
Practice Address - Phone:774-208-3004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care