Healthcare Provider Details

I. General information

NPI: 1043765233
Provider Name (Legal Business Name): ANGEL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 1ST AVE
HAVRE MT
59501-4405
US

IV. Provider business mailing address

901 1ST AVE
HAVRE MT
59501-4405
US

V. Phone/Fax

Practice location:
  • Phone: 406-390-1551
  • Fax:
Mailing address:
  • Phone: 406-390-1551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANGELA LEIGH MCGILLIVRAY
Title or Position: OWNER
Credential:
Phone: 406-390-1551