Provider Demographics
NPI:1144466632
Name:ABSOLUTELY ANGELS HOMECARE, INC.
Entity type:Organization
Organization Name:ABSOLUTELY ANGELS HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:MCCOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-522-0855
Mailing Address - Street 1:175 BRIARGATE RD APT I20
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-5038
Mailing Address - Country:US
Mailing Address - Phone:320-522-0855
Mailing Address - Fax:
Practice Address - Street 1:65712 410TH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MN
Practice Address - Zip Code:55333-1055
Practice Address - Country:US
Practice Address - Phone:507-557-2735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization