Organization
ANGEL HOME HOSPICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM OATES (OWNER)
(360) 852-4167
Entity
Organization
Contact information
Practice address
169 N GATEWAY DR STE 227, PROVIDENCE, UT 84332-9856
(360) 852-4167
Mailing address
169 N GATEWAY DR STE 170, PROVIDENCE, UT 84332-9855
(360) 852-4167
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Enumeration date
09/20/2021
Last updated
09/20/2021
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