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General NPI Number Information
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NPI Number | 1538859905
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Entity Type | Organization
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Legal Business Name | ANGEL SUPPORT HOME CARE, LLC
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Dates
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Enumeration Date | 05/10/2023
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Last Update Date | 05/10/2023
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Provider Practice Location Address
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Address Line | 1254 W CHESTER PIKE STE 105
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City | HAVERTOWN
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State | PA
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Zip | 19083-3338
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Country | US
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Telephone | 610-605-9010
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Fax | 610-605-9011
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Provider Business Mailing Address
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Address Line | 1254 W CHESTER PIKE STE 105
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City | HAVERTOWN
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State | PA
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Zip | 19083-3338
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Country | US
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Telephone | 610-605-9010
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Fax | 610-605-9011
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Authorized Official
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Title or Position | SECRETARY
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Name | MD HOSSAIN SIDDIQI
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Credential |
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Telephone | 347-468-0899
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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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