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General NPI Number Information
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NPI Number | 1891941563
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Entity Type | Organization
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Legal Business Name | HEAVENLY ANGELS HEALTHCARE INC
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 608 W JOHNSON ST STE 10
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City | RALEIGH
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State | NC
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Zip | 27603-1242
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Country | US
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Telephone | 919-995-8759
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 58672
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City | RALEIGH
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State | NC
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Zip | 27658-8672
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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 | AGENCY DIRECTOR
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Name | EBONIE BROWN
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Credential |
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Telephone | 919-995-8759
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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 |
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License Number State |
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