Organization · NPI-2

Charlies Angels Healthcare LLC

Home Health Aide · Phoenix, AZ

NPI number1205749306

StatusActive

Last updated in NPPESSep 28, 2026

Details

NPI: 1205749306
Entity type: Organization (NPI-2)
Legal business name: Charlies Angels Healthcare LLC
Organization subpart: No
Enumeration date: Sep 28, 2026
Certification date: Sep 28, 2026
Last updated: Sep 28, 2026

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
374U00000X	Home Health Aide	–	–	Yes
3747P1801X	Technician, Personal Care Attendant	–	–
376J00000X	Homemaker	–	–

Practice location

4539 N 22nd St Ste N
Phoenix, AZ 85016-4639

Phone 718-598-3077 · Fax 855-589-3052

Mailing address

4539 N 22nd St Ste N
Phoenix, AZ 85016-4639

Phone 718-598-3077 · Fax 855-589-3052

Authorized official

Ebony Bussey
Ceo/Founder
7185983077

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