Provider Demographics
NPI:1811472442
Name:RICHANGEL CARE INCORPORATED
Entity type:Organization
Organization Name:RICHANGEL CARE INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:NGOZI
Authorized Official - Last Name:IKERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-414-9102
Mailing Address - Street 1:66 KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55119-5043
Mailing Address - Country:US
Mailing Address - Phone:651-414-9102
Mailing Address - Fax:651-340-9099
Practice Address - Street 1:66 KIPLING ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55119-5043
Practice Address - Country:US
Practice Address - Phone:651-414-9102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-29
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1811472442Medicaid
MN1255672291Medicaid