Provider Demographics
NPI:1245066224
Name:GUIDING ANGELS HOMECARE LLC
Entity type:Organization
Organization Name:GUIDING ANGELS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERRYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-724-4406
Mailing Address - Street 1:642 UDELL ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-5025
Mailing Address - Country:US
Mailing Address - Phone:317-724-4406
Mailing Address - Fax:
Practice Address - Street 1:3377 FOREST MANOR AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-2261
Practice Address - Country:US
Practice Address - Phone:317-724-4406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty