Provider Demographics
NPI:1649977059
Name:JOSIE AND THE LITTLE ANGELS
Entity type:Organization
Organization Name:JOSIE AND THE LITTLE ANGELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-274-0385
Mailing Address - Street 1:257 CANCO RD APT 114
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-4279
Mailing Address - Country:US
Mailing Address - Phone:207-274-0385
Mailing Address - Fax:
Practice Address - Street 1:257 CANCO RD APT 114
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-4279
Practice Address - Country:US
Practice Address - Phone:207-274-0385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty