Healthcare Provider Details

I. General information

NPI: 1609790070
Provider Name (Legal Business Name): ANGEL HOMECARE HEALTHSERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 E STONE AVE FL 2
GREENVILLE SC
29609-5671
US

IV. Provider business mailing address

17 E STONE AVE FL 2
GREENVILLE SC
29609-5671
US

V. Phone/Fax

Practice location:
  • Phone: 864-417-8568
  • Fax:
Mailing address:
  • Phone: 864-417-8568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CORNELIA LASHELL DANIEL
Title or Position: OWNER
Credential:
Phone: 864-417-8568