Organization
ANGEL CARE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHONDRA NICOLE DAVIS MHA-GER, BSN,RN (DIRECTOR/ADMINISTRATOR)
(912) 483-3800
Entity
Organization
Contact information
Practice address
2005 VETERANS BLVD STE A13, DUBLIN, GA 31021-7504
(478) 353-1080
(478) 353-1260
Mailing address
2005 VETERANS BLVD STE A13, DUBLIN, GA 31021-7504
(478) 353-1080
(478) 353-1260
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
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
Enumeration date
03/17/2020
Last updated
01/18/2023
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