MEDICARE: ANGELS CARE

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1437742335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELS CARE

Provider Business Mailing Address
First Line	:	PO BOX 100542
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53210-0542
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1718 S 88TH ST APT 1
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53214-4368
Country	:	US
Telephone Number	:	920-791-0134
Fax Number	:

Authorized Official
Title or Position	:	OWNER/EMPLOYEE
Name	:	CECILE GAMBRELL
Credential	:
Telephone Number	:	920-791-0134

Provider Enumeration Date	:	02/11/2021
Last Update Date	:	02/11/2021

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Directions to “ANGELS CARE ” Practice Location

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