MEDICARE: WALKING ARCHANGELS HOME HEALTHCARE SERVICES LLC

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	:	1578061081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALKING ARCHANGELS HOME HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	PO BOX 50323
Second Line	:
City	:	MIDLAND
State	:	TX
Zip	:	79710-0323
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6405 BOWMAN CIR
Second Line	:
City	:	MIDLAND
State	:	TX
Zip	:	79705-9025
Country	:	US
Telephone Number	:	432-247-5002
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DIANE ESQUIBEL
Credential	:
Telephone Number	:	432-247-5002

Provider Enumeration Date	:	01/30/2018
Last Update Date	:	01/30/2018

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