Healthcare Provider Details

I. General information

NPI: 1386017705
Provider Name (Legal Business Name): NANCY'S CARING ANGELS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2015
Last Update Date: 11/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

467 E 17TH ST
HAZLE TOWNSHIP PA
18201-2007
US

IV. Provider business mailing address

467 E 17TH ST
HAZLE TOWNSHIP PA
18201-2007
US

V. Phone/Fax

Practice location:
  • Phone: 570-454-2273
  • Fax: 570-454-0628
Mailing address:
  • Phone: 570-454-2273
  • Fax: 570-454-0628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number22433601
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: NANCY A GENTLE
Title or Position: OWNER
Credential: 05/07/1946
Phone: 570-454-2273