| Organization Name: | ANGEL WINGS HOME SERVICES & CASE MANAGEMENT AGENCY, LLC |
| NPI Number: | 1043508591 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOYCE B. MOORE (DIRECTOR/CEO) |
| Mailing Address: | 517 C St South Charleston |
| State: | WV US |
| Postal Code: | 253031251 |
| Phone Number: | 3047202026 |
| Fax Number: | 3047202027 |
| NPI Enumeration Date: | 07/19/2011 |
| NPI Last Update Date: | 07/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 2254-3593 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |