Provider Demographics
NPI:1710217096
Name:GUIDING ANGELS HOME CARE
Entity Type:Organization
Organization Name:GUIDING ANGELS HOME CARE
Other - Org Name:GUIDING ANGELS HOME CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:218-334-2434
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:FRAZEE
Mailing Address - State:MN
Mailing Address - Zip Code:56544-0236
Mailing Address - Country:US
Mailing Address - Phone:218-334-2434
Mailing Address - Fax:218-334-2534
Practice Address - Street 1:111 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:FRAZEE
Practice Address - State:MN
Practice Address - Zip Code:56544-0236
Practice Address - Country:US
Practice Address - Phone:218-334-2434
Practice Address - Fax:218-334-2534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN347647251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN59-00346OtherMEDICA
MN1710217096Medicaid