Healthcare Provider Details

I. General information

NPI: 1619079787
Provider Name (Legal Business Name): ANGEL LOVIN CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 WETTERMARK ST
ALEXANDRIA LA
71301-3753
US

IV. Provider business mailing address

2131 WETTERMARK ST
ALEXANDRIA LA
71301-3753
US

V. Phone/Fax

Practice location:
  • Phone: 318-445-3141
  • Fax: 318-445-3149
Mailing address:
  • Phone: 318-445-3141
  • Fax: 318-445-3149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. CAROLYN JEAN DESSELLES
Title or Position: OWNER
Credential: RN
Phone: 318-442-6435