Angel Wings Care Home Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ANGEL WINGS CARE HOME INC.

Doing business as

Angel Wings Care Home III

Practice address

5420 San Martin Way
Antioch, CA 94531-8506

Phone

(925) 392-8915

NPI assigned

Nov 9, 2021

Last updated

Nov 9, 2021By 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

Anita Yabut

Title

Owner

Phone

(510) 329-4926

Specialties & licenses 1

Addresses

Other names 1

• Angel Wings Care Home III Doing business as

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1184380651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 SAN MARTIN WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318506",
            "telephone_number": "925-392-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 SAN MARTIN WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318506",
            "telephone_number": "925-392-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL WINGS CARE HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "YABUT",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-329-4926"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angel Wings Care Home III",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Antioch, CA
• Providers in Antioch, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.