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General NPI Number Information
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NPI Number | 1427590108
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Entity Type | Organization
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Legal Business Name | ANGEL SENIOR CARE
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Dates
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Enumeration Date | 11/10/2016
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 8512 N WALL ST
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City | SPOKANE
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State | WA
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Zip | 99208-6164
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Country | US
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Telephone | 509-720-7972
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Fax | 888-239-5488
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Provider Business Mailing Address
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Address Line | 8512 N WALL ST
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City | SPOKANE
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State | WA
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Zip | 99208-6164
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Country | US
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Telephone | 509-720-7972
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Fax | 888-239-5488
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Authorized Official
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Title or Position | PRESIDENT
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Name | VAUGHN YOUNG
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Credential |
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Telephone | 509-499-4567
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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 | 603165643
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License Number State | WA
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