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General NPI Number Information
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NPI Number | 1871892521
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Entity Type | Organization
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Legal Business Name | ANGEL'S OF JOY HOME HEALTH, LLC
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 2235 E FLAMINGO RD SUITE # 107
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City | LAS VEGAS
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State | NV
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Zip | 89119-5129
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Country | US
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Telephone | 702-893-3011
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Fax | 702-893-3012
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Provider Business Mailing Address
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Address Line | 2235 E FLAMINGO RD SUITE # 107
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City | LAS VEGAS
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State | NV
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Zip | 89119-5129
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Country | US
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Telephone | 702-893-3011
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Fax | 702-893-3012
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | KANDICE L ASHY FERNSTROM
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Credential |
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Telephone | 901-494-0666
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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 | 5758PCS-3
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License Number State | NV
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