Provider Demographics
NPI:1598521155
Name:ANGEL NATION LLC
Entity Type:Organization
Organization Name:ANGEL NATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:A
Authorized Official - Last Name:KRIEGBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-460-8588
Mailing Address - Street 1:222 BRENT DR W APT D
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-4810
Mailing Address - Country:US
Mailing Address - Phone:937-460-8588
Mailing Address - Fax:
Practice Address - Street 1:222 BRENT DR W APT D
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-4810
Practice Address - Country:US
Practice Address - Phone:937-460-8588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care
No332U00000XSuppliersHome Delivered Meals
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care