Provider Demographics
NPI:1013656594
Name:ANGENICUS HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:ANGENICUS HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGERLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUBBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-205-5876
Mailing Address - Street 1:4124 QUEBEC AVE N STE 102
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-1200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4124 QUEBEC AVE N STE 102
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-1200
Practice Address - Country:US
Practice Address - Phone:763-205-5571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health