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General NPI Number Information
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NPI Number | 1750805826
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Entity Type | Organization
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Legal Business Name | COMFORT CARE ANGELS LLC
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 08/04/2017
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Provider Practice Location Address
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Address Line | 403 8TH ST S STE 195
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City | MOORHEAD
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State | MN
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Zip | 56560-2813
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Country | US
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Telephone | 612-735-6950
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Fax |
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Provider Business Mailing Address
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Address Line | 403 8TH ST S STE 195
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City | MOORHEAD
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State | MN
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Zip | 56560-2813
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | OLGUINE ORIENTAL
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Credential |
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Telephone | 612-735-6950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 381595
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License Number State | MN
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