Provider Demographics
NPI:1508076183
Name:LITTLE ANGEL CARE HOME, LLC
Entity Type:Organization
Organization Name:LITTLE ANGEL CARE HOME, LLC
Other - Org Name:FAMILY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARILOU
Authorized Official - Middle Name:A
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-746-8027
Mailing Address - Street 1:2570 KEYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-1364
Mailing Address - Country:US
Mailing Address - Phone:775-746-8027
Mailing Address - Fax:775-746-9256
Practice Address - Street 1:2570 KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-1364
Practice Address - Country:US
Practice Address - Phone:775-746-8027
Practice Address - Fax:775-746-9256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities