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General NPI Number Information
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NPI Number | 1972015279
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Entity Type | Organization
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Legal Business Name | ANGEL'S CHARITY LLC
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Dates
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Enumeration Date | 10/27/2017
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Last Update Date | 10/27/2017
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Provider Practice Location Address
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Address Line | 7002 GRAHAM RD STE 121
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-4048
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Country | US
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Telephone | 317-436-7748
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Fax |
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Provider Business Mailing Address
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Address Line | 7002 GRAHAM RD STE 121
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-4048
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Country | US
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Telephone | 317-436-7748
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ELLESE NICOLE WALKER
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Credential | HHA
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Telephone | 317-652-6225
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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 | HHA1502805
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License Number State | IN
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