Provider Demographics
NPI:1184395824
Name:ANGEL HOME CARE LLC
Entity type:Organization
Organization Name:ANGEL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:KARBAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-799-2556
Mailing Address - Street 1:1208 WESTPORT BEACH WAY UNIT B
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8857
Mailing Address - Country:US
Mailing Address - Phone:701-799-2556
Mailing Address - Fax:
Practice Address - Street 1:1208 WESTPORT BEACH WAY UNIT B
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8857
Practice Address - Country:US
Practice Address - Phone:701-799-2556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty