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General NPI Number Information
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NPI Number | 1366625303
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Entity Type | Organization
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Legal Business Name | ARCHANGEL PERSONAL CARE ATTENDANT SERVICES,LLC
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 3501 HOLIDAY DR 407
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City | NEW ORLEANS
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State | LA
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Zip | 70114-8202
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Country | US
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Telephone | 504-366-0494
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Fax | 504-366-0492
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Provider Business Mailing Address
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Address Line | 3501 HOLIDAY DR 407
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City | NEW ORLEANS
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State | LA
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Zip | 70114-8202
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Country | US
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Telephone | 504-366-0494
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Fax | 504-366-0492
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. ROSLAND RENEE' DRIVER
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Credential | RN,MPA
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Telephone | 504-366-0494
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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 | PCA11634
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License Number State | LA
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