Healthcare Provider Details

I. General information

NPI: 1740536929
Provider Name (Legal Business Name): TRAVEL ANGELS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2012
Last Update Date: 09/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5282 STATION CIR
NORCROSS GA
30071-4501
US

IV. Provider business mailing address

5282 STATION CIR
NORCROSS GA
30071-4501
US

V. Phone/Fax

Practice location:
  • Phone: 770-849-0270
  • Fax: 770-849-0279
Mailing address:
  • Phone: 770-849-0270
  • Fax: 770-849-0279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MS. MERLYNETTE MORRIS-GLEATON
Title or Position: FOUNDER/DIRECTOR
Credential:
Phone: 770-849-0270