Healthcare Provider Details

I. General information

NPI: 1679909485
Provider Name (Legal Business Name): DAY ANGELS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2013
Last Update Date: 09/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 THORN RIDGE RD
FRIENDLY WV
26146-7459
US

IV. Provider business mailing address

1016 THORN RIDGE RD
FRIENDLY WV
26146-7459
US

V. Phone/Fax

Practice location:
  • Phone: 304-652-2230
  • Fax:
Mailing address:
  • Phone: 304-652-2230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number22899459
License Number StateWV

VIII. Authorized Official

Name: MRS. GRETTA G SMITH
Title or Position: OWNER/OPERATOR
Credential:
Phone: 304-652-2230