MEDICARE: ANGELS ON ASSIGNMENT, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	576988	TX

General Provider Information

NPI Number	:	1336382613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELS ON ASSIGNMENT, LLC

Provider Business Mailing Address
First Line	:	939 LAUREL GREEN RD
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-2856
Country	:	US
Telephone Number	:	832-452-1934
Fax Number	:	281-499-6844

Provider Business Practice Location Address
First Line	:	939 LAUREL GREEN RD
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-2856
Country	:	US
Telephone Number	:	832-452-1934
Fax Number	:	281-499-6844

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	MS. INGRID FLANNEL ASHLEY
Credential	:	R.N.
Telephone Number	:	832-452-1934

Provider Enumeration Date	:	04/15/2009
Last Update Date	:	04/15/2009

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