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General NPI Number Information
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NPI Number | 1821661067
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Entity Type | Organization
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Legal Business Name | ANGEL HOUSE, LLC
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 07/23/2021
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Provider Practice Location Address
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Address Line | 115 HAWKINS ST
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City | FRANKLIN
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State | LA
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Zip | 70538
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Country | US
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Telephone | 337-578-4614
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Fax |
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Provider Business Mailing Address
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Address Line | 119 HAWKINS ST
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City | FRANKLIN
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State | LA
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Zip | 70538-3336
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Country | US
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Telephone | 337-578-4614
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TAMARIA JONISE HAWKINS
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Credential |
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Telephone | 337-578-4614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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