Provider Demographics
NPI:1346852787
Name:ANGELS OF LIGHT HOME CARE LLC,
Entity Type:Organization
Organization Name:ANGELS OF LIGHT HOME CARE LLC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:PROF
Authorized Official - First Name:N CANDICE
Authorized Official - Middle Name:CANDICE
Authorized Official - Last Name:KATIKATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-890-3689
Mailing Address - Street 1:175 CAPITAL BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3914
Mailing Address - Country:US
Mailing Address - Phone:860-890-3689
Mailing Address - Fax:959-200-4101
Practice Address - Street 1:175 CAPITAL BLVD FL 4
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3914
Practice Address - Country:US
Practice Address - Phone:860-890-3689
Practice Address - Fax:959-200-4101
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANGELS OF LIGHT HOME CARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health