Provider Demographics
NPI:1265716161
Name:ANGELLE'S HOSPICE & PALLIATIVE CARE
Entity type:Organization
Organization Name:ANGELLE'S HOSPICE & PALLIATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUDREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-432-2300
Mailing Address - Street 1:2030 AVALON PKWY
Mailing Address - Street 2:SUITE 435
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-3023
Mailing Address - Country:US
Mailing Address - Phone:678-432-2300
Mailing Address - Fax:678-432-2301
Practice Address - Street 1:2030 AVALON PKWY
Practice Address - Street 2:SUITE 435
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3023
Practice Address - Country:US
Practice Address - Phone:678-432-2300
Practice Address - Fax:678-432-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-11
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based