Provider Demographics
NPI:1669123147
Name:MY ANGELS HOME CARE LLC
Entity type:Organization
Organization Name:MY ANGELS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZANIAB
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-582-2920
Mailing Address - Street 1:6300 THEODORE ST FL 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-3116
Mailing Address - Country:US
Mailing Address - Phone:267-582-2920
Mailing Address - Fax:215-330-4499
Practice Address - Street 1:6300 THEODORE ST FL 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-3116
Practice Address - Country:US
Practice Address - Phone:267-582-2920
Practice Address - Fax:215-330-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-15
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care