# ANGEL PRIVATE DUTY HOMECARE, LLC

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

## Provider details

- **NPI number:** 1851843098
- **Authorized official:** SHAUNTAI GREER (ADMINSTRATOR)
- **Authorized official phone:** (901) 857-8143

## Contact information

- **Practice address:** 160 CLAIREMONT AVE STE 200, DECATUR, GA 30030-2546
- **Practice address phone:** (678) 954-5717
- **Practice address fax:** (678) 954-5801
- **Mailing address:** 160 CLAIREMONT AVE STE 200, DECATUR, GA 30030-2546
- **Mailing address phone:** (678) 954-5717
- **Mailing address fax:** (678) 954-5801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 033R1625 | GA | Yes |
| 251J00000X | Nursing Care Agency | 033R1625 | GA | — |
| 253Z00000X | In Home Supportive Care Agency | 033R1625 | GA | — |

## Other

- **Enumeration date:** 11/03/2016
- **Last updated:** 01/05/2017