Provider Demographics
NPI:1508398595
Name:CARING ANGELS IN HOME CARE LLC
Entity Type:Organization
Organization Name:CARING ANGELS IN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISANDRA
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:CAMPOS NAZARIO
Authorized Official - Suffix:
Authorized Official - Credentials:CNA2
Authorized Official - Phone:971-302-1289
Mailing Address - Street 1:23117 NE ARATA RD
Mailing Address - Street 2:
Mailing Address - City:WOOD VILLAGE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-2702
Mailing Address - Country:US
Mailing Address - Phone:503-465-8394
Mailing Address - Fax:
Practice Address - Street 1:23117 NE ARATA RD
Practice Address - Street 2:
Practice Address - City:WOOD VILLAGE
Practice Address - State:OR
Practice Address - Zip Code:97060-2702
Practice Address - Country:US
Practice Address - Phone:503-465-8394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR129966198251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health