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General NPI Number Information
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NPI Number | 1508203407
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Entity Type | Organization
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Legal Business Name | TOUCH BY AN ANGEL HEALTHCARE INC.
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Dates
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Enumeration Date | 05/31/2013
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Last Update Date | 05/31/2013
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Provider Practice Location Address
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Address Line | 2861 TOBACCO RD
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City | HEPHZIBAH
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State | GA
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Zip | 30815-7003
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Country | US
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Telephone | 706-790-5836
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Fax | 706-790-0767
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Provider Business Mailing Address
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Address Line | 2861 TOBACCO RD
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City | HEPHZIBAH
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State | GA
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Zip | 30815-7003
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Country | US
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Telephone | 706-790-5836
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Fax | 706-790-0767
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Authorized Official
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Title or Position | CEO
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Name | MS. DOROTHY HURST
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Credential | LPN
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Telephone | 706-814-9691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | LCB20120001059
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License Number State | GA
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