Healthcare Provider Details

I. General information

NPI: 1235279894
Provider Name (Legal Business Name): ANGELIC HANDS HOME HEALTH AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 12/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6591 CLEARWATER DR
OXFORD NC
27565-4808
US

IV. Provider business mailing address

6591 CLEARWATER DR
OXFORD NC
27565-4808
US

V. Phone/Fax

Practice location:
  • Phone: 919-482-4898
  • Fax: 919-693-8351
Mailing address:
  • Phone: 919-482-4898
  • Fax: 919-693-8351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC3558
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MRS. SOPHIA SMITH HARRIS
Title or Position: DIRECTOR
Credential:
Phone: 919-482-4898