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General NPI Number Information
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NPI Number | 1063987071
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Entity Type | Individual
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Provider Name | RHONDA RENEE RHODEN ANGEL
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Gender | Female
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Dates
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Enumeration Date | 10/05/2018
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 1606 WILLOW VIEW RD
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City | URBANA
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State | IL
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Zip | 61802-7475
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Country | US
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Telephone | 217-377-6018
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Fax | 217-607-0588
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Provider Business Mailing Address
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Address Line | 2425 E NEVADA ST
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City | URBANA
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State | IL
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Zip | 61802-4542
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Country | US
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Telephone | 217-377-6018
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HF115142
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License Number State | IL
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