Healthcare Provider Details

I. General information

NPI: 1174457154
Provider Name (Legal Business Name): ANGELIC HANDS CARE HOME INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24661 KIM CIR
LAGUNA HILLS CA
92653-4314
US

IV. Provider business mailing address

24661 KIM CIR
LAGUNA HILLS CA
92653-4314
US

V. Phone/Fax

Practice location:
  • Phone: 949-290-3917
  • Fax:
Mailing address:
  • Phone: 949-290-3917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: LEAH ANN FAJARDO
Title or Position: CORPORATE REPRESENTATIVE
Credential:
Phone: 949-290-3917