Healthcare Provider Details

I. General information

NPI: 1679137954
Provider Name (Legal Business Name): STOKES ANGELS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 S GRAND AVE
CARTHAGE MO
64836-7803
US

IV. Provider business mailing address

PO BOX 83
JOPLIN MO
64802-0083
US

V. Phone/Fax

Practice location:
  • Phone: 417-781-1000
  • Fax:
Mailing address:
  • Phone: 417-781-1000
  • Fax: 417-691-8644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: CAROL MICHELLE KUEHN
Title or Position: CHIEF OPERATION OFFICER
Credential:
Phone: 417-781-1000