Healthcare Provider Details

I. General information

NPI: 1740799022
Provider Name (Legal Business Name): ANGEL DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2017
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 W WAGNER CT
GILBERT AZ
85233
US

IV. Provider business mailing address

500 S GILBERT RD
GILBERT AZ
85296-2202
US

V. Phone/Fax

Practice location:
  • Phone: 732-593-7490
  • Fax:
Mailing address:
  • Phone: 480-630-6211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MIHIR PATEL
Title or Position: OWNER
Credential:
Phone: 732-593-7490