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NPI Code Detail

MEDICARE: ALL ANGEL CARE,LLC

MEDICARE: ALL ANGEL CARE,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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1700439627
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALL ANGEL CARE,LLC
Provider Business Mailing Address
First Line : 2398 LENORA CHURCH RD STE 102
Second Line :
City : SNELLVILLE
State : GA
Zip : 30078-6921
Country : US
Telephone Number : 770-809-3777
Fax Number : 770-809-3777
Provider Business Practice Location Address
First Line : 2398 LENORA CHURCH RD STE 102
Second Line :
City : SNELLVILLE
State : GA
Zip : 30078-6921
Country : US
Telephone Number : 770-809-3777
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : EVANDER DIKE SYLVANUS
Credential :
Telephone Number : 770-809-3777
Provider Enumeration Date : 07/19/2019
Last Update Date : 07/19/2019

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Directions to “ALL ANGEL CARE,LLC ” Practice Location

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