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General NPI Number Information
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NPI Number | 1497227730
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Entity Type | Organization
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Legal Business Name | ANGELIC TOUCH HOMECARE 1SERVICES INC.
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Dates
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Enumeration Date | 12/27/2018
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Last Update Date | 12/27/2018
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Provider Practice Location Address
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Address Line | 1501 NANCY ST
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City | BARSTOW
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State | CA
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Zip | 92311-2534
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Country | US
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Telephone | 909-678-8894
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 NANCY ST
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City | BARSTOW
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State | CA
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Zip | 92311-2534
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Country | US
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Telephone | 909-678-8894
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/CEO/OWNER
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Name | MS. KOU LILA SUMWABE
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Credential |
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Telephone | 909-678-6698
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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 |
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