Provider Demographics
NPI:1225531288
Name:KJ ANGEL SERVICES, LLC
Entity Type:Organization
Organization Name:KJ ANGEL SERVICES, LLC
Other - Org Name:VISITING ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMERSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-899-9575
Mailing Address - Street 1:3133 FLOYD BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51108-1419
Mailing Address - Country:US
Mailing Address - Phone:712-899-9575
Mailing Address - Fax:
Practice Address - Street 1:3133 FLOYD BLVD STE B
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51108-1419
Practice Address - Country:US
Practice Address - Phone:712-899-9575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care