Provider Demographics
NPI:1467610782
Name:ANGELS SENIOR HOME SOLUTIONS
Entity Type:Organization
Organization Name:ANGELS SENIOR HOME SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-251-0441
Mailing Address - Street 1:1330 WIN HENTSCHEL BLVD STE 203B
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-4149
Mailing Address - Country:US
Mailing Address - Phone:765-463-2100
Mailing Address - Fax:765-464-0139
Practice Address - Street 1:1330 WIN HENTSCHEL BLVD STE 203B
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-4149
Practice Address - Country:US
Practice Address - Phone:765-463-2100
Practice Address - Fax:765-464-0139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-23
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN011253251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN011253OtherINDIANA STATE DEPARTMENT OF HEALTH