MEDICARE: HEALING ANGELS NURSING SERVICES, INC.

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

General Provider Information

NPI Number	:	1518472869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING ANGELS NURSING SERVICES, INC.

Provider Business Mailing Address
First Line	:	3538 W BEVERLY BLVD
Second Line	:	SUITE C
City	:	MONTEBELLO
State	:	CA
Zip	:	90640
Country	:	US
Telephone Number	:	323-721-1443
Fax Number	:	323-721-1447

Provider Business Practice Location Address
First Line	:	3538 W BEVERLY BLVD
Second Line	:	SUITE C
City	:	MONTEBELLO
State	:	CA
Zip	:	90640
Country	:	US
Telephone Number	:	323-721-1443
Fax Number	:	323-721-1447

Authorized Official
Title or Position	:	SECRETARY OF THE BOARD
Name	:	MRS. HRIPSIME MENDELYAN
Credential	:
Telephone Number	:	323-721-1443

Provider Enumeration Date	:	12/08/2017
Last Update Date	:	12/08/2017

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