Provider Demographics
NPI:1376870410
Name:ANGELICARE LLC
Entity Type:Organization
Organization Name:ANGELICARE LLC
Other - Org Name:VISITING ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LLC MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAGBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-544-6300
Mailing Address - Street 1:5871 CEDAR LAKE RD.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ST. LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1478
Mailing Address - Country:US
Mailing Address - Phone:952-544-6300
Mailing Address - Fax:
Practice Address - Street 1:5871 CEDAR LAKE RD S
Practice Address - Street 2:SUITE 101
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1472
Practice Address - Country:US
Practice Address - Phone:952-544-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN343034251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health