| Organization Name: | ANGELITE PCH CENTER, LLC |
| NPI Number: | 1376856773 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NNAEMEKA CHUKKA (ADMINISTRATOR) |
| Mailing Address: | 210 Hill Pine Rd Fairburn |
| State: | GA US |
| Postal Code: | 302136052 |
| Phone Number: | 6784893841 |
| Fax Number: | 7707031553 |
| NPI Enumeration Date: | 07/15/2010 |
| NPI Last Update Date: | 12/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |