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General NPI Number Information
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NPI Number | 1174147805
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Entity Type | Organization
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Legal Business Name | ANGELIC HOME HEALTH, LLC
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Dates
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Enumeration Date | 05/28/2020
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 8828 BISON CLUB DR APT D
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-2832
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Country | US
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Telephone | 614-371-3227
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Fax |
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Provider Business Mailing Address
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Address Line | 8828 BISON CLUB DR APT D
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-2832
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Country | US
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Telephone | 614-371-3227
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ABDIRAHMAN MOHAMMED
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Credential |
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Telephone | 812-655-3909
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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 |
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License Number State |
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