Healthcare Provider Details

I. General information

NPI: 1497992051
Provider Name (Legal Business Name): PROSPEROUS ANGELS DOMESTIC & HEALTHCARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2009
Last Update Date: 01/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22843 TWISTING PINE DR
SPRING TX
77373-4207
US

IV. Provider business mailing address

22843 TWISTING PINE DR
SPRING TX
77373-4207
US

V. Phone/Fax

Practice location:
  • Phone: 832-332-6896
  • Fax: 281-645-8556
Mailing address:
  • Phone: 832-332-6896
  • Fax: 281-645-8556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. GODRENIA ZENON
Title or Position: OWNER , PRESIDENT
Credential:
Phone: 832-332-6896