Archangel Palm Homecare Services LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

ARCHANGEL PALM HOMECARE SERVICES LLC

Practice address

413 Acadia LN
Forney, TX 75126-4221

Phone

(469) 438-4493

NPI assigned

Apr 22, 2021

Organization subpart

No

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

Authorized official

Name

Jessie Garzon Mendiola

Title

Managing Member

Phone

(469) 438-4493

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1194307876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 ACADIA LN",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751264221",
            "telephone_number": "469-438-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 ACADIA LN",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751264221",
            "telephone_number": "469-438-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHANGEL PALM HOMECARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "MENDIOLA",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_middle_name": "GARZON",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "469-438-4493"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https",
            "affiliation": "N",
            "address_1": "413 Acadia Ln",
            "city": "Forney",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751264221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• In Home Supportive Care Agency in Forney, TX
• Providers in Forney, TX by specialty
• In Home Supportive Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.