=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053616011
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE ANGELS HOME HEALTH CARE SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2011
-----------------------------------------------------
Last Update Date | 03/23/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2244 S HAMILTON RD STE 101
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43232-4390
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-577-1126
-----------------------------------------------------
Fax | 614-577-1185
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2244 S HAMILTON RD STE 101
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43232-4390
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-577-1126
-----------------------------------------------------
Fax | 614-577-1185
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/PRESIDENT
-----------------------------------------------------
Name | NGOZI C AKABUAKU
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-577-1126
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1985276
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------