Healthcare Provider Details

I. General information

NPI: 1871325225
Provider Name (Legal Business Name): ARMS OF AN ANGEL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2024
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 COMMODORE DR NW
ATLANTA GA
30318-6355
US

IV. Provider business mailing address

875 COMMODORE DR NW
ATLANTA GA
30318-6355
US

V. Phone/Fax

Practice location:
  • Phone: 419-779-0931
  • Fax:
Mailing address:
  • Phone: 419-779-0931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: LATOYA EWING
Title or Position: CEO
Credential:
Phone: 419-779-0931