Healthcare Provider Details

I. General information

NPI: 1881543361
Provider Name (Legal Business Name): ANGELS CARE PERSONAL CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E CENTENNIAL DR UNIT 653
OAK CREEK WI
53154-8928
US

IV. Provider business mailing address

PO BOX 653
OAK CREEK WI
53154-0653
US

V. Phone/Fax

Practice location:
  • Phone: 414-975-2863
  • Fax:
Mailing address:
  • Phone: 414-975-2863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EMONI GAMBRELL-TOLIVER
Title or Position: PROVIDER
Credential:
Phone: 414-975-2863