Provider Demographics
NPI:1740421056
Name:ANGELS OF LIFE, INC.
Entity Type:Organization
Organization Name:ANGELS OF LIFE, INC.
Other - Org Name:ANGELS OF LIFE HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESEDENT/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GEGUIEFFA
Authorized Official - Middle Name:JEBRAWN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-358-4348
Mailing Address - Street 1:11109 E 48TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-2301
Mailing Address - Country:US
Mailing Address - Phone:816-358-4348
Mailing Address - Fax:816-358-4349
Practice Address - Street 1:11109 E 48TH TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133-2301
Practice Address - Country:US
Practice Address - Phone:816-358-4348
Practice Address - Fax:816-358-4349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO171397251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health