Organization
ANGELS ON YOUR SIDE HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAIMEKA HAGGANS (CEO)
(870) 455-3004
Entity
Organization
Contact information
Practice address
2022 E BROADWAY ST, FORREST CITY, AR 72335-7881
(870) 455-3004
Mailing address
PO BOX 462, FORREST CITY, AR 72336-0462
(870) 455-3004
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232714732
—
AR
05
—
232898797
—
AR
05
—
265101757
—
AR
05
—
273118767
—
AR
Enumeration date
05/24/2019
Last updated
11/03/2021
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