Healthcare Provider Details

I. General information

NPI: 1780117317
Provider Name (Legal Business Name): ANGELS FROM HEAVEN HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 ALBEMARLE RD SUITE 110
CHARLOTTE NC
28205
US

IV. Provider business mailing address

4921 ALBEMARLE RD SUITE 110
CHARLOTTE NC
28205
US

V. Phone/Fax

Practice location:
  • Phone: 864-641-6111
  • Fax: 888-492-9389
Mailing address:
  • Phone: 864-641-6111
  • Fax: 888-492-9389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC3189
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHC3189
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHC3189
License Number StateNC

VIII. Authorized Official

Name: KATHERINE CUTLER
Title or Position: OWNER
Credential:
Phone: 864-641-6111