Organization Active NPI

Charlies Angels Healthcare LLC

  • In Home Supportive Care Agency
  • Far Rockaway, NY
National Provider Identifier
1598435695
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
CHARLIES ANGELS HEALTHCARE LLC
Practice address
412 Beach 38TH St
Far Rockaway, NY 11691-1514
Phone
(610) 619-6069
NPI assigned
Sep 20, 2021
Last updated
Jul 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

412 Beach 38TH St
Far Rockaway, NY 11691-1514

Mailing address

412 Beach 38TH St
Far Rockaway, NY 11691-1514
Phone (718) 598-3077

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1598435695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 BEACH 38TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911514",
            "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": "412 BEACH 38TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911514",
            "telephone_number": "610-619-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLIES ANGELS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-20",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "BUSSEY",
        "authorized_official_first_name": "EBONY",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "718-598-3077"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.