Provider Demographics
NPI:1144190513
Name:TRAVELING ANGELS LLC
Entity type:Organization
Organization Name:TRAVELING ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION
Authorized Official - Prefix:
Authorized Official - First Name:BONITA
Authorized Official - Middle Name:
Authorized Official - Last Name:REVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-851-7399
Mailing Address - Street 1:2325 SELMA AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1305
Mailing Address - Country:US
Mailing Address - Phone:850-851-7399
Mailing Address - Fax:
Practice Address - Street 1:2325 SELMA AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1305
Practice Address - Country:US
Practice Address - Phone:850-851-7399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty