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General NPI Number Information
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NPI Number | 1306439849
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Entity Type | Organization
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Legal Business Name | EARTH ANGELS HOME CARE LLC
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Dates
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Enumeration Date | 02/16/2021
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 6 CROSBY ST APT 8
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City | ORONO
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State | ME
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Zip | 04473-5406
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Country | US
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Telephone | 859-206-3939
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 216
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City | MILFORD
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State | ME
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Zip | 04461-0216
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Country | US
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Telephone | 859-206-3939
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DOMINIC ST LOUIS
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Credential |
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Telephone | 859-206-3939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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