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NPI Code Detail

MEDICARE: ARMS OF AN ANGEL PROVIDER SERVICES LLC

MEDICARE: ARMS OF AN ANGEL PROVIDER 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
13747P1801XPersonal Care Attendant

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
120210589389OTHERTXDBA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598352593
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARMS OF AN ANGEL PROVIDER SERVICES LLC
Provider Business Mailing Address
First Line : 118 BROADWAY ST STE 203
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78205-1950
Country : US
Telephone Number : 210-245-0245
Fax Number : 210-200-6063
Provider Business Practice Location Address
First Line : 118 BROADWAY ST STE 203
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78205-1950
Country : US
Telephone Number : 210-245-0245
Fax Number : 210-200-6063
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. ANA LISA GONZALES
Credential : LPN
Telephone Number : 210-245-0245
Provider Enumeration Date : 12/23/2020
Last Update Date : 05/03/2022

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Directions to “ARMS OF AN ANGEL PROVIDER SERVICES LLC ” Practice Location

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