# ANGEL CARE HOME CARE LLC

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

## Provider details

- **NPI number:** 1184250631
- **Authorized official:** SHONDRA NICOLE DAVIS MHA-GER, BSN,RN (DIRECTOR/ADMINISTRATOR)
- **Authorized official phone:** (912) 483-3800

## Contact information

- **Practice address:** 2005 VETERANS BLVD STE A13, DUBLIN, GA 31021-7504
- **Practice address phone:** (478) 353-1080
- **Practice address fax:** (478) 353-1260
- **Mailing address:** 2005 VETERANS BLVD STE A13, DUBLIN, GA 31021-7504
- **Mailing address phone:** (478) 353-1080
- **Mailing address fax:** (478) 353-1260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/17/2020
- **Last updated:** 01/18/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003231057A | — | GA |
| 05 | — | 003231057B | — | GA |
| 01 | — | 025-R-2032 | GEORGIA DCH PRIVATE HOME CARE PROVIDER PERMIT NUMBER | GA |