MEDICARE: KELLY'S ANGELS 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1881524015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KELLY'S ANGELS INC.

Provider Business Mailing Address
First Line	:	23421 COLUMBUS RD
Second Line	:
City	:	BEDFORD HTS
State	:	OH
Zip	:	44146-2949
Country	:	US
Telephone Number	:	440-477-8543
Fax Number	:

Provider Business Practice Location Address
First Line	:	23421 COLUMBUS RD
Second Line	:
City	:	BEDFORD HTS
State	:	OH
Zip	:	44146-2949
Country	:	US
Telephone Number	:	440-477-8543
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KELLY LYN MUNDY
Credential	:
Telephone Number	:	449-477-8543

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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Directions to “KELLY'S ANGELS INC. ” Practice Location

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