Provider Demographics
NPI:1528466133
Name:KAYLIN'S ANGELCARE, LLC
Entity type:Organization
Organization Name:KAYLIN'S ANGELCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:260-403-8125
Mailing Address - Street 1:127 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH WHITLEY
Mailing Address - State:IN
Mailing Address - Zip Code:46787-1390
Mailing Address - Country:US
Mailing Address - Phone:260-388-3819
Mailing Address - Fax:866-661-3437
Practice Address - Street 1:127 S STATE ST
Practice Address - Street 2:
Practice Address - City:SOUTH WHITLEY
Practice Address - State:IN
Practice Address - Zip Code:46787-1390
Practice Address - Country:US
Practice Address - Phone:260-388-3819
Practice Address - Fax:866-661-3437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN140135541251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health