ANGEL'S PLACE (NPI# 1417556689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417556689 |
| Entity Type | Organization |
| Organization Name | ANGEL'S PLACE |
| Practice Address |
909 Highland Dr Kilgore TX 75662-4040 |
| Practice Telephone | 9039186690 |
| Mailing Telephone | 9039186690 |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-20 |
| Authorized Official Name | YULY VANESSA OLOWO (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 9039186690 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | Nursing Service Related Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ANGEL'S PLACE ADULT CARE HOME, LLC | 1919 Wareham Ln, Newberg, OR 97132 |
| Colorado Business Entities | Angel's Place LLC | 12198 Kittredge St, Brighton, CO 80603 |
| Street Address |
909 HIGHLAND DR |
| City | KILGORE |
| State | TX |
| Zip Code | 75662-4040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346890621 | Linda Gail Watson | Technician | 190 Glendale St, Kilgore, TX 75662 | 2019-09-18 |
| 1174185151 | Jennifer Darlene Franks | Registered Nurse | 6144 Gateway Center Pmb # 320, Kilgore, TX 75662 | 2019-07-01 |
| 1215363312 | Kilgore Integrated Health Pllc | Chiropractor | 726 Us Highway 259 N, Kilgore, TX 75662 | 2013-09-20 |
| 1407172240 | Jeffrey Alan Davis | Specialist/Technologist | 300 N. Kilgore Street, Kilgore, TX 75662 | 2010-04-19 |
| 1396923777 | Rachel Thunder Rose Wyatt | Physical Therapist | 1200 Dudley Road, Kilgore, TX 75662 | 2008-02-07 |
| 1346313673 | Brookshire Grocery Company | Pharmacy | 747 Hwy 259 North, Attention Pharmacy Dept, Kilgore, TX 75662 | 2006-11-16 |
| 1417026451 | Jeffery John Pinkerton | Optometrist | 800 Highway 259 North, Kilgore, TX 75662 | 2006-11-06 |
| 1831205004 | Joseph Claude De Graffenried Jr. | Dentist | 238 Lawrence St, Kilgore, TX 75662 | 2006-08-21 |
| 1235159500 | Charles Robert Cottier | Chiropractor | 316 Henderson, Kilgome, TX 75662 | 2006-07-20 |
| 1346509494 | Kelton Hospice, Inc. | Hospice Care, Community Based | 1100 Stone Road, Suite 269, Kilgore, TX 75662 | 2012-05-10 |
| Find all providers in zip 75662 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607480 | Lisseth Carolina Bautista | Adult Companion | 25218 Spring Iris Ln, Katy, TX 77494-5580 | 2020-10-25 |
| 1134733397 | Edna Renee Phillips | Adult Companion | 3352 Jan Ct, Katy, TX 77493-1379 | 2020-09-04 |
| 1396355483 | J Person Inc Dba Living Word Home Care Service | Adult Companion | 1202 Evans Rd Apt 1225, San Antonio, TX 78258-6969 | 2020-08-04 |
| 1841808771 | Kidz Plus Medical Clinic | Adult Companion | 8613 Martin Luther King Blvd, Houston, TX 77033-2307 | 2020-07-16 |
| 1679199806 | Tammy Swan | Adult Companion | 4606 Fm 1960 Rd W Ste 640, Houston, TX 77069-4600 | 2020-06-23 |
| 1942826318 | Lacinder Roseann King | Adult Companion | 1205 Switchgrass Ln, Crowley, TX 76036-4341 | 2020-06-22 |
| 1841815768 | Bridget Danielle Hill | Adult Companion | 2417 Castle Creek Dr, Little Elm, TX 75068-4887 | 2020-06-16 |
| 1811512528 | Marina Martin Del Campo | Adult Companion | 11030 Oasis Dr, El Paso, TX 79936-1023 | 2020-06-09 |
| 1710513239 | Suzanne F Moore | Adult Companion | 5801 Rayburn Dr, Fort Worth, TX 76133-3026 | 2020-03-16 |
| 1356972343 | Christopher E Graham | Adult Companion | 3006 Bee Caves Rd Ste A217, Austin, TX 78746-5849 | 2020-01-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.