Angelic Home Healthcare

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

ANGELIC HOME HEALTHCARE

Practice address

7734 S Shoreline Blvd
Benton, AR 72019-8472

Phone

(501) 773-8055

NPI assigned

Jul 3, 2024

Last updated

Jul 3, 2024By 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

Kesha Mathews

Title

Owner

Phone

(501) 773-8055

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1902642598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7734 S SHORELINE BLVD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720198472",
            "telephone_number": "501-773-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7734 S SHORELINE BLVD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720198472",
            "telephone_number": "501-773-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELIC HOME HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "MATHEWS",
        "authorized_official_first_name": "KESHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-773-8055"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Benton, AR
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• In Home Supportive Care Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.