Provider Demographics
NPI:1861926065
Name:ANGEL'S HOME HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:ANGEL'S HOME HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:NABAGEREKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-886-4311
Mailing Address - Street 1:8525 EDINBROOK XING
Mailing Address - Street 2:STE 3
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1900
Mailing Address - Country:US
Mailing Address - Phone:763-208-6015
Mailing Address - Fax:
Practice Address - Street 1:8525 EDINBROOK XING
Practice Address - Street 2:STE 3
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1900
Practice Address - Country:US
Practice Address - Phone:763-208-6015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN380824251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health