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General NPI Number Information
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NPI Number | 1871266544
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Entity Type | Organization
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Legal Business Name | ANGEL SHINES HOME CARE LLC
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Dates
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Enumeration Date | 07/28/2021
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 8330 LYNDON B JOHNSON FWY
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City | DALLAS
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State | TX
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Zip | 75243-1166
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Country | US
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Telephone | 469-867-3256
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Fax |
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Provider Business Mailing Address
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Address Line | 1434 GREENWICH DR
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City | ALLEN
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State | TX
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Zip | 75013-4681
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Country | US
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Telephone | 469-867-3256
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHINE I THOMAS
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Credential |
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Telephone | 469-867-3256
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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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