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General NPI Number Information
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NPI Number | 1508508292
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Entity Type | Organization
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Legal Business Name | EARTH ANGELS HEALTHCARE, LLC.
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 22217 VERBENA PKWY
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City | SPICEWOOD
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State | TX
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Zip | 78669-6306
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Country | US
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Telephone | 512-668-9561
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Fax |
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Provider Business Mailing Address
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Address Line | 22217 VERBENA PKWY
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City | SPICEWOOD
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State | TX
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Zip | 78669-6306
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Country | US
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Telephone | 512-668-9561
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Fax | 855-746-0001
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NSIKAN ESENOWO
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Credential |
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Telephone | 832-890-1351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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