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General NPI Number Information
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NPI Number | 1104338714
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Entity Type | Organization
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Legal Business Name | ANGEL STAR HELPING HANDS, LLC
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Dates
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Enumeration Date | 11/05/2017
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Last Update Date | 11/05/2017
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Provider Practice Location Address
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Address Line | 144 SECRETARY TRL
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City | PALM COAST
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State | FL
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Zip | 32164-4404
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Country | US
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Telephone | 386-527-0660
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Fax | 386-313-5233
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Provider Business Mailing Address
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Address Line | 144 SECRETARY TRL
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City | PALM COAST
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State | FL
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Zip | 32164-4404
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. WANDREA A BROWN
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Credential |
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Telephone | 386-527-0660
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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 | 234873
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License Number State | FL
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