# PURE ANGELS HOME CARE SERVICES

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

## Provider details

- **NPI number:** 1104245034
- **Authorized official:** MRS. SHIRLEY J BRESHERS-SOUTHWELL (OWNER)
- **Authorized official phone:** (404) 500-5425

## Contact information

- **Practice address:** 5300 MEMORIAL DR, SUITE 134, STONE MOUNTAIN, GA 30083-3148
- **Practice address phone:** (404) 500-5425
- **Practice address fax:** (404) 500-5427
- **Mailing address:** 5300 MEMORIAL DR, SUITE 134, STONE MOUNTAIN, GA 30083-3148
- **Mailing address phone:** (404) 500-5425
- **Mailing address fax:** (404) 500-5427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 044-R-1261 | GA | Yes |

## Other

- **Enumeration date:** 04/08/2014
- **Last updated:** 04/08/2014