Healthcare Provider Details

I. General information

NPI: 1235897877
Provider Name (Legal Business Name): ANGELS CARE HOME HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E BARSTOW AVE STE 113
FRESNO CA
93710-5023
US

IV. Provider business mailing address

125 E BARSTOW AVE STE 113
FRESNO CA
93710-5023
US

V. Phone/Fax

Practice location:
  • Phone: 559-355-6932
  • Fax: 559-449-9644
Mailing address:
  • Phone: 559-293-4975
  • Fax: 559-293-4976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. RIPSIME LILY GOUFF
Title or Position: SECRETARY
Credential:
Phone: 559-355-6932