Healthcare Provider Details

I. General information

NPI: 1649183708
Provider Name (Legal Business Name): KISSANGELS HOMECARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5534 ALBEMARLE RD STE 110
CHARLOTTE NC
28212-3630
US

IV. Provider business mailing address

829 ARCHDALE DR
CHARLOTTE NC
28217-0217
US

V. Phone/Fax

Practice location:
  • Phone: 704-421-2126
  • Fax:
Mailing address:
  • Phone: 704-421-2126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANGELA NJOKU
Title or Position: OWNER
Credential:
Phone: 704-421-2126