Provider Demographics
NPI:1174313282
Name:ANGEL HEART HOMECARE LLC
Entity type:Organization
Organization Name:ANGEL HEART HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IZUCHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIWODO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-816-8119
Mailing Address - Street 1:6131 COASTAL GROVE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2078
Mailing Address - Country:US
Mailing Address - Phone:713-816-8119
Mailing Address - Fax:
Practice Address - Street 1:6131 COASTAL GROVE LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2078
Practice Address - Country:US
Practice Address - Phone:713-816-8119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health