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General NPI Number Information
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NPI Number | 1962945832
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Entity Type | Organization
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Legal Business Name | EARTH ANGELS HEALTHCARE LLC
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 11/28/2016
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Provider Practice Location Address
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Address Line | 85 BAGBY DR STE 305
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3707
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Country | US
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Telephone | 205-567-6101
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Fax |
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Provider Business Mailing Address
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Address Line | 85 BAGBY DR STE 305
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3707
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Country | US
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Telephone | 205-567-6101
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | SHELIA JOLLY
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Credential |
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Telephone | 205-567-6101
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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 | 008-158
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License Number State | AL
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