MEDICARE: CARING FOR ANGELS 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1639505811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARING FOR ANGELS LLC

Provider Business Mailing Address
First Line	:	1812 VINCENT AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-2820
Country	:	US
Telephone Number	:	612-229-6879
Fax Number	:	612-886-6262

Provider Business Practice Location Address
First Line	:	1812 VINCENT AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-2820
Country	:	US
Telephone Number	:	612-229-6879
Fax Number	:	612-886-6262

Authorized Official
Title or Position	:	OWNER
Name	:	MS. LASANIA IISHIA SHAVON ODA
Credential	:
Telephone Number	:	612-229-6879

Provider Enumeration Date	:	09/19/2013
Last Update Date	:	09/19/2013

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Directions to “CARING FOR ANGELS LLC ” Practice Location

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