Provider Demographics
NPI:1225821689
Name:ARCHANGEL SERVICES LLC
Entity type:Organization
Organization Name:ARCHANGEL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-219-8866
Mailing Address - Street 1:26 W MAPLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405
Mailing Address - Country:US
Mailing Address - Phone:937-219-8866
Mailing Address - Fax:
Practice Address - Street 1:26 W MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405
Practice Address - Country:US
Practice Address - Phone:937-219-8866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARCHANGEL SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2472R0900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherRenal DialysisGroup - Multi-Specialty
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization