Healthcare Provider Details

I. General information

NPI: 1164129839
Provider Name (Legal Business Name): ANGELS IN GUARD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 HWY 93 N SUITE 2A
VICTOR MT
59875
US

IV. Provider business mailing address

PO BOX 634
LOLO MT
59847-0634
US

V. Phone/Fax

Practice location:
  • Phone: 406-880-2854
  • Fax: 406-625-0611
Mailing address:
  • Phone: 406-880-2854
  • Fax: 406-625-0611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: LISA ROSCHELL CAMPBELL
Title or Position: FOUNDER/ CEO
Credential:
Phone: 406-880-2854