Provider Demographics
NPI:1295027779
Name:AGING ANGELS LLC
Entity Type:Organization
Organization Name:AGING ANGELS LLC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SLAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-754-1300
Mailing Address - Street 1:2585 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-2051
Mailing Address - Country:US
Mailing Address - Phone:815-754-1300
Mailing Address - Fax:815-754-1500
Practice Address - Street 1:2585 SYCAMORE RD
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2051
Practice Address - Country:US
Practice Address - Phone:815-754-1300
Practice Address - Fax:815-754-1500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1997208253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care