Healthcare Provider Details

I. General information

NPI: 1932025277
Provider Name (Legal Business Name): HANDS OF ANGELS SENIOR SUPPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3831 TACK ROOM RD
AUBREY TX
76227-4971
US

IV. Provider business mailing address

3831 TACK ROOM RD
AUBREY TX
76227-4971
US

V. Phone/Fax

Practice location:
  • Phone: 817-733-6685
  • Fax:
Mailing address:
  • Phone: 817-733-6685
  • 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: LIZE BUKASA KABONA
Title or Position: OWNER
Credential:
Phone: 817-733-6685