Provider Demographics
NPI:1487208294
Name:ANGELS ON WHEELS
Entity Type:Organization
Organization Name:ANGELS ON WHEELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:RIECKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-661-3650
Mailing Address - Street 1:75734 WEST RD
Mailing Address - Street 2:
Mailing Address - City:BUTTERNUT
Mailing Address - State:WI
Mailing Address - Zip Code:54514-9149
Mailing Address - Country:US
Mailing Address - Phone:715-661-3650
Mailing Address - Fax:
Practice Address - Street 1:75734 WEST RD
Practice Address - Street 2:
Practice Address - City:BUTTERNUT
Practice Address - State:WI
Practice Address - Zip Code:54514-9149
Practice Address - Country:US
Practice Address - Phone:715-661-3650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty