MEDICARE: ANGEL TOUCH PCA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1124961958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL TOUCH PCA LLC

Provider Business Mailing Address
First Line	:	10923 ROYAL HIGHLANDS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4364
Country	:	US
Telephone Number	:	909-377-6520
Fax Number	:

Provider Business Practice Location Address
First Line	:	10923 ROYAL HIGHLANDS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4364
Country	:	US
Telephone Number	:	909-377-6520
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JERAMIE TIBON
Credential	:
Telephone Number	:	909-377-6520

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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