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General NPI Number Information
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NPI Number | 1861707465
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Entity Type | Organization
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Legal Business Name | ANGELS OF LIFE MEDICAL TEAM & CENTER
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 08/09/2010
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Provider Practice Location Address
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Address Line | 166 BRIGHTON ST
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City | EAST PITTSBURGH
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State | PA
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Zip | 15112-1302
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Country | US
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Telephone | 412-351-1083
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Fax |
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Provider Business Mailing Address
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Address Line | 166 BRIGHTON ST
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City | EAST PITTSBURGH
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State | PA
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Zip | 15112-1302
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COORDINATOR/OWNER
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Name | MICHAEL DECARIO
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Credential |
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Telephone | 412-351-1083
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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 | 3969620
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License Number State | PA
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