Provider Demographics
NPI:1972906840
Name:LITTLE ANGELS CARE GIVER LLC
Entity Type:Organization
Organization Name:LITTLE ANGELS CARE GIVER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEOUVISAK
Authorized Official - Middle Name:POVISA
Authorized Official - Last Name:PEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-259-5337
Mailing Address - Street 1:5 WEBBER ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-1649
Mailing Address - Country:US
Mailing Address - Phone:978-259-5337
Mailing Address - Fax:978-710-3726
Practice Address - Street 1:5 WEBBER ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-1649
Practice Address - Country:US
Practice Address - Phone:978-259-5337
Practice Address - Fax:978-710-3726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8409251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health