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General NPI Number Information
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NPI Number | 1063977338
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Entity Type | Organization
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Legal Business Name | RICAS ANGELS HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 01/31/2019
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Last Update Date | 01/31/2019
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Provider Practice Location Address
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Address Line | 221 N ELM ST
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City | LUMBERTON
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State | NC
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Zip | 28358-5647
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Country | US
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Telephone | 910-674-9271
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7503
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City | LUMBERTON
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State | NC
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Zip | 28359-3095
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Country | US
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Telephone | 910-674-9271
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOSEPH MCDANIEL JR.
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Credential | M.ED., MBA
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Telephone | 910-316-0372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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