Provider Demographics
NPI:1164129839
Name:ANGELS IN GUARD LLC
Entity Type:Organization
Organization Name:ANGELS IN GUARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ROSCHELL
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-880-2854
Mailing Address - Street 1:PO BOX 634
Mailing Address - Street 2:
Mailing Address - City:LOLO
Mailing Address - State:MT
Mailing Address - Zip Code:59847-0634
Mailing Address - Country:US
Mailing Address - Phone:406-880-2854
Mailing Address - Fax:406-625-0611
Practice Address - Street 1:499 RIDGEWAY DR
Practice Address - Street 2:
Practice Address - City:LOLO
Practice Address - State:MT
Practice Address - Zip Code:59847-9661
Practice Address - Country:US
Practice Address - Phone:406-880-2854
Practice Address - Fax:406-625-0611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty