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General NPI Number Information
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NPI Number | 1720422215
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Entity Type | Organization
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Legal Business Name | ANGEL HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 04/26/2013
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Provider Practice Location Address
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Address Line | 71 PALATINE PARK RD STE 3
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City | GERMANTOWN
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State | NY
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Zip | 12526-5340
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Country | US
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Telephone | 518-537-2070
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Fax | 518-537-2071
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Provider Business Mailing Address
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Address Line | 71 PALATINE PARK RD STE 3
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City | GERMANTOWN
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State | NY
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Zip | 12526-5340
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Country | US
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Telephone | 518-537-2070
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Fax | 518-537-2071
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Authorized Official
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Title or Position | CO-ADMINISTRATOR
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Name | MS. PEGGY A. WATSON
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Credential | RN-BC
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Telephone | 518-537-2070
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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 | 1286L001
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License Number State | NY
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