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General NPI Number Information
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NPI Number | 1245804459
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Entity Type | Organization
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Legal Business Name | GYPSY'S ANGELS HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 1115 E 114TH ST
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City | CLEVELAND
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State | OH
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Zip | 44108-3744
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Country | US
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Telephone | 216-322-3909
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Fax | 216-274-9838
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Provider Business Mailing Address
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Address Line | 1115 E 114TH ST
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City | CLEVELAND
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State | OH
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Zip | 44108-3744
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Country | US
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Telephone | 216-322-3909
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Fax | 216-274-9838
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Authorized Official
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Title or Position | OWNER
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Name | CHIQUITTA RUSSELL
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Credential |
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Telephone | 216-322-3909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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