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General NPI Number Information
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NPI Number | 1316104201
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Entity Type | Organization
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Legal Business Name | ANGELIC HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 12/04/2018
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Provider Practice Location Address
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Address Line | 7220 SAINT CHARLES ROCK RD
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City | SAINT LOUIS
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State | MO
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Zip | 63133-1758
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Country | US
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Telephone | 314-361-5000
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Fax | 314-361-5001
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Provider Business Mailing Address
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Address Line | PO BOX 38254
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City | SAINT LOUIS
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State | MO
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Zip | 63138-0254
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Country | US
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Telephone | 314-565-6416
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Fax | 314-869-1184
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. TWANICE L. MITCHELL
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Credential |
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Telephone | 314-565-6416
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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 | MO
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | B00173634
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | B00173634
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License Number State | MO
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