Provider Demographics
NPI:1932075678
Name:SUPPORTING ANGELS LLC
Entity type:Organization
Organization Name:SUPPORTING ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-518-9147
Mailing Address - Street 1:2000 AUBURN DR
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4314
Mailing Address - Country:US
Mailing Address - Phone:463-224-6732
Mailing Address - Fax:
Practice Address - Street 1:2000 AUBURN DR
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4314
Practice Address - Country:US
Practice Address - Phone:463-224-6732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUPPORTING ANGELS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty