Angel Home, Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

ANGEL HOME, INC.

Practice address

2607 Rhonda CT
Duluth, GA 30096-4128

Phone

(678) 863-1232

Fax

(404) 445-8323

NPI assigned

Jun 24, 2018

Last updated

Feb 6, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Moses Park

Title

Administrator

Phone

(678) 863-1232

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644105600000",
    "number": "1184119059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 RHONDA CT",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964128",
            "telephone_number": "678-863-1232",
            "fax_number": "404-445-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 RHONDA CT",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964128",
            "telephone_number": "678-863-1232",
            "fax_number": "404-445-8323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-24",
        "last_updated": "2022-02-06",
        "certification_date": "2022-02-06",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "MOSES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "678-863-1232"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Duluth, GA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.