Provider Demographics
NPI:1972006674
Name:ANGEL HEARTS IN HOME CARE LLC
Entity Type:Organization
Organization Name:ANGEL HEARTS IN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:RMA
Authorized Official - Phone:517-894-6054
Mailing Address - Street 1:1524 KENNEDY DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4722
Mailing Address - Country:US
Mailing Address - Phone:517-894-6054
Mailing Address - Fax:
Practice Address - Street 1:1524 KENNEDY DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4722
Practice Address - Country:US
Practice Address - Phone:517-894-6054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty