Provider Demographics
NPI:1912778705
Name:ANGEL CARE AT HOME LLC
Entity Type:Organization
Organization Name:ANGEL CARE AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTORY
Authorized Official - Middle Name:
Authorized Official - Last Name:NJINDANGAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-410-1438
Mailing Address - Street 1:5601 NW 72ND ST # 212F
Mailing Address - Street 2:
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73132-5931
Mailing Address - Country:US
Mailing Address - Phone:405-367-7113
Mailing Address - Fax:
Practice Address - Street 1:5601 NW 72ND ST # 212F
Practice Address - Street 2:
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73132-5931
Practice Address - Country:US
Practice Address - Phone:405-367-7113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care