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General NPI Number Information
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NPI Number | 1457159147
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Entity Type | Organization
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Legal Business Name | ANGELIC ANGELS HOME CARE, LLC
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 713 FALL AVE
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City | KOOSKIA
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State | ID
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Zip | 83539
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Country | US
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Telephone | 208-451-1327
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Fax |
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Provider Business Mailing Address
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Address Line | 713 FALL AVE
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City | KOOSKIA
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State | ID
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Zip | 83539
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Country | US
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Telephone | 208-451-1327
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KRISTY R STAMPER
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Credential | MBA, BS
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Telephone | 208-451-1327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333300000X
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Taxonomy Name | Emergency Response System Companies
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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 | 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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