Organization
HEAVENLY ANGELS HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER LYNN DE LOS REYES (OWNER-PRESIDENT)
(858) 444-7094
Entity
Organization
Contact information
Practice address
4709 MOUNT ABERNATHY AVE, SAN DIEGO, CA 92117-3340
(858) 444-7904
(858) 278-2093
Mailing address
4709 MOUNT ABERNATHY AVE, SAN DIEGO, CA 92117-3340
(858) 444-7904
(858) 278-2093
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
B2010022157
CA
251E00000X
Home Health Agency
Primary
B2010022157
CA
251J00000X
Nursing Care Agency
B2010022157
CA
253Z00000X
In Home Supportive Care Agency
B2010022157
CA
Other
Enumeration date
11/22/2010
Last updated
11/22/2010
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