Provider Demographics
NPI:1750181053
Name:DAISY'S CARE HOME LLC
Entity type:Organization
Organization Name:DAISY'S CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELITA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARGILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-224-5690
Mailing Address - Street 1:1815 S 22ND ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40210-2149
Mailing Address - Country:US
Mailing Address - Phone:502-224-5690
Mailing Address - Fax:
Practice Address - Street 1:1815 S 22ND ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40210-2149
Practice Address - Country:US
Practice Address - Phone:502-224-5690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty