Provider Demographics
NPI:1104224013
Name:AVID ANGELS CAREGIVING, INC
Entity type:Organization
Organization Name:AVID ANGELS CAREGIVING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-481-0400
Mailing Address - Street 1:7152 MOON CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46241-3668
Mailing Address - Country:US
Mailing Address - Phone:317-504-5084
Mailing Address - Fax:866-649-5663
Practice Address - Street 1:7152 MOON CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-3668
Practice Address - Country:US
Practice Address - Phone:317-481-0400
Practice Address - Fax:866-649-5663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health