Provider Demographics
NPI:1992116800
Name:ANGEL'S TO ASSIST HOME HEALTH AGENCY,LLC
Entity type:Organization
Organization Name:ANGEL'S TO ASSIST HOME HEALTH AGENCY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIZZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-680-9656
Mailing Address - Street 1:10800 W FLORISSANT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-2412
Mailing Address - Country:US
Mailing Address - Phone:314-680-9656
Mailing Address - Fax:314-395-3535
Practice Address - Street 1:10800 W FLORISSANT AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-2412
Practice Address - Country:US
Practice Address - Phone:314-680-9656
Practice Address - Fax:314-395-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health