Provider Demographics
NPI:1043596711
Name:ANGELS BY YOUR SIDE HOME CARE LLC
Entity Type:Organization
Organization Name:ANGELS BY YOUR SIDE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:EUGENIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGENIMANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-877-9289
Mailing Address - Street 1:9820 SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-3479
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9820 SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-3479
Practice Address - Country:US
Practice Address - Phone:440-877-9289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2011721251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health