MEDICARE: ANGEL BRIGHT HOME HEALTH,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	3747P1801X	Personal Care Attendant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001013054	OTHER	TX	COMMUNITY BASES ALTERNATI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437224060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL BRIGHT HOME HEALTH,INC.

Provider Business Mailing Address
First Line	:	3221 HOLLY ROAD
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78415-3216
Country	:	US
Telephone Number	:	361-986-1102
Fax Number	:	361-986-1152

Provider Business Practice Location Address
First Line	:	3221 HOLLY ROAD
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78415-3216
Country	:	US
Telephone Number	:	361-986-1102
Fax Number	:	361-986-1152

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. BLANCH E FERNANDEZ
Credential	:
Telephone Number	:	361-986-1102

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	10/21/2022

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