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General NPI Number Information
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NPI Number | 1386135929
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Entity Type | Organization
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Legal Business Name | AGING ANGELS LLC
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Dates
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Enumeration Date | 05/18/2018
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Last Update Date | 05/18/2018
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Provider Practice Location Address
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Address Line | 5647 WYNDALE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19131-1305
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Country | US
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Telephone | 267-276-2421
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Fax | 267-292-3227
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Provider Business Mailing Address
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Address Line | 5647 WYNDALE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19131-1305
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Country | US
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Telephone | 267-276-2421
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Fax | 267-292-3227
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | FALISA HILL
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Credential |
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Telephone | 267-276-2421
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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 | 35293601
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License Number State | PA
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