Provider Demographics
NPI:1447052949
Name:ILLIANAS ANGEL HEALTHCARE LLC
Entity type:Organization
Organization Name:ILLIANAS ANGEL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DERDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPAIX-FONTIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-867-8669
Mailing Address - Street 1:4419 ARBOR CREST LN
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-5256
Mailing Address - Country:US
Mailing Address - Phone:956-867-8669
Mailing Address - Fax:
Practice Address - Street 1:4419 ARBOR CREST LN
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-5256
Practice Address - Country:US
Practice Address - Phone:956-867-8669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based