Provider Demographics
NPI:1871892521
Name:ANGEL'S OF JOY HOME HEALTH, LLC
Entity type:Organization
Organization Name:ANGEL'S OF JOY HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KANDICE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ASHY FERNSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-494-0666
Mailing Address - Street 1:2235 E FLAMINGO RD
Mailing Address - Street 2:SUITE # 107
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5129
Mailing Address - Country:US
Mailing Address - Phone:702-893-3011
Mailing Address - Fax:702-893-3012
Practice Address - Street 1:2235 E FLAMINGO RD
Practice Address - Street 2:SUITE # 107
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5129
Practice Address - Country:US
Practice Address - Phone:702-893-3011
Practice Address - Fax:702-893-3012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5758PCS-3251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health