Healthcare Provider Details

I. General information

NPI: 1689589301
Provider Name (Legal Business Name): ANGELS ON THE EARTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 9TH AVE
CHICKASAW AL
36611-2602
US

IV. Provider business mailing address

212 9TH AVE
CHICKASAW AL
36611-2602
US

V. Phone/Fax

Practice location:
  • Phone: 251-367-3343
  • Fax:
Mailing address:
  • Phone: 251-367-3343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: KEESHA TAYLOR
Title or Position: ADMINISTRATOR
Credential:
Phone: 251-367-3343