# ANGELUS HOME HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104184761
- **Authorized official:** MILES R BALLESTEROS (ADMINISTRATOR)
- **Authorized official phone:** (909) 999-0587

## Contact information

- **Practice address:** 211 S LAUREL AVE, ONTARIO, CA 91762-3833
- **Practice address phone:** (909) 999-0587
- **Practice address fax:** (909) 781-2449
- **Mailing address:** 211 S LAUREL AVE, ONTARIO, CA 91762-3833
- **Mailing address phone:** (909) 999-0587

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/01/2012
- **Last updated:** 10/02/2024