Provider Demographics
NPI:1972348605
Name:ANGEL HEARTS CARE
Entity type:Organization
Organization Name:ANGEL HEARTS CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONY
Authorized Official - Middle Name:WANJOHI
Authorized Official - Last Name:MBUGUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-927-3797
Mailing Address - Street 1:600 THORNHILL LN
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-4466
Mailing Address - Country:US
Mailing Address - Phone:678-927-3797
Mailing Address - Fax:
Practice Address - Street 1:1031 CAMBRIDGE SQ
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-1869
Practice Address - Country:US
Practice Address - Phone:770-744-8985
Practice Address - Fax:770-264-4869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care