Healthcare Provider Details

I. General information

NPI: 1710046933
Provider Name (Legal Business Name): A STAR FOR AN ANGEL HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 S WILLOW STREET
GASTONIA NC
28054-2792
US

IV. Provider business mailing address

229 S WILLOW STREET
GASTONIA NC
28054-2792
US

V. Phone/Fax

Practice location:
  • Phone: 704-865-8431
  • Fax: 704-865-8689
Mailing address:
  • Phone: 704-865-8431
  • Fax: 704-865-8689

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 Code251J00000X
TaxonomyNursing Care Agency
License NumberHC3150
License Number StateNC

VIII. Authorized Official

Name: MRS. CRYSTAL BROWN WRIGHT
Title or Position: CEO AGENCY DIRECTOR
Credential:
Phone: 704-865-8431