Provider Demographics
NPI:1104428192
Name:OLIVIAS ANGELS HOME CARR LLC
Entity type:Organization
Organization Name:OLIVIAS ANGELS HOME CARR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LANAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEEPLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-487-9598
Mailing Address - Street 1:4894 GUERLEY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-4038
Mailing Address - Country:US
Mailing Address - Phone:513-487-9598
Mailing Address - Fax:
Practice Address - Street 1:4894 GUERLEY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-4038
Practice Address - Country:US
Practice Address - Phone:513-487-9598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care