Healthcare Provider Details

I. General information

NPI: 1073049052
Provider Name (Legal Business Name): ANGELIC HANDS HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2236 MERRITT WAY
ARLINGTON TX
76018-3131
US

IV. Provider business mailing address

2236 MERRITT WAY
ARLINGTON TX
76018-3131
US

V. Phone/Fax

Practice location:
  • Phone: 254-466-8795
  • Fax:
Mailing address:
  • Phone: 254-466-8795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number863013
License Number StateTX

VIII. Authorized Official

Name: LORNA MARIE GRIGGS
Title or Position: CLINICAL MANGER
Credential: RN
Phone: 254-466-8795