Provider Demographics
NPI:1487268579
Name:AMAZING SOULS HOME CARE LLC
Entity type:Organization
Organization Name:AMAZING SOULS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:LUCAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NYANGORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-735-9898
Mailing Address - Street 1:2612 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-7177
Mailing Address - Country:US
Mailing Address - Phone:484-735-9898
Mailing Address - Fax:
Practice Address - Street 1:2612 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-7177
Practice Address - Country:US
Practice Address - Phone:484-735-9898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care