Organization
ANGEL HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS HORNSBY (VICE PRESIDENT/DIRECTING MANAGER)
(833) 762-6435
Entity
Organization
Contact information
Practice address
1265 W SHAW AVE STE 100, FRESNO, CA 93711-3717
(183) 376-2643
Mailing address
1265 W SHAW AVE STE 100, FRESNO, CA 93711-3717
(183) 376-2643
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104700047
HOME CARE ORGANIZATION LICENSE
CA
Enumeration date
12/09/2021
Last updated
12/09/2021
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