MEDICARE: ANGELLICARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780117911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELLICARE INC.

Provider Business Mailing Address
First Line	:	17325 EUCLID AVE
Second Line	:	SUITE 2060
City	:	CLEVELAND
State	:	OH
Zip	:	44112-1247
Country	:	US
Telephone Number	:	216-714-2273
Fax Number	:	216-485-2909

Provider Business Practice Location Address
First Line	:	17325 EUCLID AVE
Second Line	:	SUITE 2060
City	:	CLEVELAND
State	:	OH
Zip	:	44112-1247
Country	:	US
Telephone Number	:	216-714-2273
Fax Number	:	216-485-2909

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ANGELIA D PACE
Credential	:
Telephone Number	:	216-714-2273

Provider Enumeration Date	:	04/05/2017
Last Update Date	:	04/05/2017

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Directions to “ANGELLICARE INC. ” Practice Location

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