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General NPI Number Information
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NPI Number | 1861780009
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Entity Type | Organization
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Legal Business Name | CIRCLE OF ANGELS HOME HEALTH CARE
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Dates
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Enumeration Date | 07/20/2011
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 2375 E MAIN ST STE A302
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City | SPARTANBURG
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State | SC
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Zip | 29307-1432
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Country | US
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Telephone | 864-579-3346
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Fax | 919-217-0932
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Provider Business Mailing Address
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Address Line | 3005 VILLAGE PARK DR SUITE 204B
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City | KNIGHTDALE
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State | NC
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Zip | 27545-7993
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Country | US
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Telephone | 919-217-0933
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Fax | 919-217-0932
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DARRELL KENYATTA TENNIE
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Credential |
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Telephone | 919-217-0933
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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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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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