Provider Demographics
NPI:1295458701
Name:SHILOH ANGELS HOMECARE LLC
Entity type:Organization
Organization Name:SHILOH ANGELS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOASIAKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-262-7547
Mailing Address - Street 1:264 N MAIN ST STE 7
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-1815
Mailing Address - Country:US
Mailing Address - Phone:413-262-7547
Mailing Address - Fax:
Practice Address - Street 1:264 N MAIN ST STE 7
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-1815
Practice Address - Country:US
Practice Address - Phone:413-262-7547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care