MEDICARE: ANGEL'S TO ASSIST HOME HEALTH AGENCY,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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1992116800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL'S TO ASSIST HOME HEALTH AGENCY,LLC

Provider Business Mailing Address
First Line	:	10800 W FLORISSANT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-2412
Country	:	US
Telephone Number	:	314-680-9656
Fax Number	:	314-395-3535

Provider Business Practice Location Address
First Line	:	10800 W FLORISSANT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-2412
Country	:	US
Telephone Number	:	314-680-9656
Fax Number	:	314-395-3535

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KIZZIE DAVIS
Credential	:
Telephone Number	:	314-680-9656

Provider Enumeration Date	:	05/13/2014
Last Update Date	:	05/13/2014

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