Provider Demographics
NPI:1780238394
Name:MICHAELAS ANGELIC CAREGIVERS LLC
Entity type:Organization
Organization Name:MICHAELAS ANGELIC CAREGIVERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TASHARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEYWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-497-3120
Mailing Address - Street 1:455 ST ANDREWS RD BLDG D
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-4486
Mailing Address - Country:US
Mailing Address - Phone:803-497-3120
Mailing Address - Fax:803-497-3899
Practice Address - Street 1:455 ST ANDREWS RD BLDG D
Practice Address - Street 2:SUITE 3A
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-4486
Practice Address - Country:US
Practice Address - Phone:803-497-3120
Practice Address - Fax:803-497-3120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty