Healthcare Provider Details

I. General information

NPI: 1912715301
Provider Name (Legal Business Name): ANGEL 44 CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4707 W PALMAIRE AVE
GLENDALE AZ
85301-2723
US

IV. Provider business mailing address

4707 W PALMAIRE AVE
GLENDALE AZ
85301-2723
US

V. Phone/Fax

Practice location:
  • Phone: 480-388-4935
  • Fax:
Mailing address:
  • Phone: 480-388-4935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: MRS. FATUMA AHMED
Title or Position: OWNER
Credential:
Phone: 480-388-4935