MEDICARE: ANGELS OF JOY HOME HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	2000237-319	NV

General Provider Information

NPI Number	:	1033544838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELS OF JOY HOME HEALTH SERVICES

Provider Business Mailing Address
First Line	:	3376 S EASTERN AVE STE 166
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3367
Country	:	US
Telephone Number	:	702-893-3011
Fax Number	:	702-893-3012

Provider Business Practice Location Address
First Line	:	3376 S EASTERN AVE STE 166
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3367
Country	:	US
Telephone Number	:	702-893-3011
Fax Number	:	702-893-3012

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MRS. KANDICE ASHY-FERNSTROM
Credential	:
Telephone Number	:	901-494-0666

Provider Enumeration Date	:	09/11/2013
Last Update Date	:	09/11/2013

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