| Organization Name: | ANGEL WINGS NURSING SERVICES LLC |
| NPI Number: | 1245654961 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARIA TARESS BOLDEN (DIRECTOR) |
| Mailing Address: | 320 Brookes Dr 200 Hazelwood |
| State: | MO US |
| Postal Code: | 630422736 |
| Phone Number: | 3149422994 |
| Fax Number: | |
| NPI Enumeration Date: | 02/17/2014 |
| NPI Last Update Date: | 02/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 374U00000X |
| License Number: | LC1357020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Nursing Service Related Providers |
| Taxonomy Classification: | Home Health Aide |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. |