Organization Active NPI

Charlies Angels Healthcare LLC

  • Home Health Aide
  • Phoenix, AZ
National Provider Identifier
1205749306
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Legal business name
CHARLIES ANGELS HEALTHCARE LLC
Practice address
4539 N 22ND St Ste N
Phoenix, AZ 85016-4639
Phone
(718) 598-3077
Fax
(855) 589-3052
NPI assigned
Sep 28, 2026
Last updated
Sep 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Authorized official

Name
Ebony Bussey
Title
Ceo/Founder
Phone
(718) 598-3077

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X NU
Home Health Aide 374U00000X NU Primary
Homemaker 376J00000X NU

Addresses

Primary practice location

4539 N 22ND St Ste N
Phoenix, AZ 85016-4639

Mailing address

4539 N 22ND St Ste N
Phoenix, AZ 85016-4639
Phone (718) 598-3077

NPI Registry JSON

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

{
    "created_epoch": "1790553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790553600000",
    "number": "1205749306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4539 N 22ND ST STE N",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164639",
            "telephone_number": "718-598-3077",
            "fax_number": "855-589-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4539 N 22ND ST STE N",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164639",
            "telephone_number": "718-598-3077",
            "fax_number": "855-589-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLIES ANGELS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-28",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A",
        "authorized_official_last_name": "BUSSEY",
        "authorized_official_first_name": "EBONY",
        "authorized_official_title_or_position": "CEO/FOUNDER",
        "authorized_official_telephone_number": "718-598-3077"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.