Healthcare Provider Details

I. General information

NPI: 1740022359
Provider Name (Legal Business Name): ANGEL HEART HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 MAYFIELD DR
COATESVILLE PA
19320-3071
US

IV. Provider business mailing address

124 MAYFIELD DR
COATESVILLE PA
19320-3071
US

V. Phone/Fax

Practice location:
  • Phone: 215-828-2507
  • Fax:
Mailing address:
  • Phone: 215-828-2507
  • Fax:

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: MS. TIFFINI BURNS
Title or Position: CEO
Credential:
Phone: 215-828-2507