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General NPI Number Information
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NPI Number | 1720200264
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Entity Type | Organization
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Legal Business Name | ANGEL LOVIN' CARE
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2131 WETTERMARK ST
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3753
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Country | US
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Telephone | 318-445-3141
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Fax | 318-445-3149
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Provider Business Mailing Address
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Address Line | 2131 WETTERMARK ST
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3753
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Country | US
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Telephone | 318-445-3141
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Fax | 318-445-3149
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CAROLYN D DESSELLES
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Credential | R.N.
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Telephone | 318-445-3141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | 311ZA0620X
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License Number State | LA
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