Provider Demographics
NPI:1740937986
Name:JODIS ANGELS LLC
Entity type:Organization
Organization Name:JODIS ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JODILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZAREK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-809-5443
Mailing Address - Street 1:1006 PERKINS JONES RD
Mailing Address - Street 2:APT C5
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483
Mailing Address - Country:US
Mailing Address - Phone:330-809-5443
Mailing Address - Fax:
Practice Address - Street 1:1006 PERKINS JONES RD
Practice Address - Street 2:APT C5
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483
Practice Address - Country:US
Practice Address - Phone:330-809-5443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JODIS ANGELS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty