Healthcare Provider Details

I. General information

NPI: 1679326029
Provider Name (Legal Business Name): NUANGELS HOME CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9708 N KINGS HWY STE 11
MYRTLE BEACH SC
29572-4008
US

IV. Provider business mailing address

9708 N KINGS HWY STE 11
MYRTLE BEACH SC
29572-4008
US

V. Phone/Fax

Practice location:
  • Phone: 843-663-0864
  • Fax: 843-300-1018
Mailing address:
  • Phone: 843-663-0864
  • Fax: 919-869-1671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier1679326029
Identifier TypeMEDICAID
Identifier StateSC
Identifier Issuer
# 2
Identifier1245656578
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: MRS. LATARSHA CRUMPLER
Title or Position: CEO
Credential:
Phone: 919-672-5592