MEDICARE: VILLAGE ANGELS, INC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1326671777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE ANGELS, INC

Provider Business Mailing Address
First Line	:	198 CARMONA RD STE 12
Second Line	:
City	:	HOT SPRINGS VILLAGE
State	:	AR
Zip	:	71909-2919
Country	:	US
Telephone Number	:	501-922-2224
Fax Number	:	501-204-5006

Provider Business Practice Location Address
First Line	:	198 CARMONA RD STE 12
Second Line	:
City	:	HOT SPRINGS VILLAGE
State	:	AR
Zip	:	71909-2919
Country	:	US
Telephone Number	:	501-922-2224
Fax Number	:	501-204-5006

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. ROBERT R HEBERT
Credential	:	OWNER
Telephone Number	:	501-922-2224

Provider Enumeration Date	:	02/13/2020
Last Update Date	:	02/27/2020

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Directions to “VILLAGE ANGELS, INC ” Practice Location

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