Provider Demographics
NPI:1306647086
Name:MAE'S CARE AND COMFORT ANGELS LLC
Entity type:Organization
Organization Name:MAE'S CARE AND COMFORT ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-967-2229
Mailing Address - Street 1:4609 GRAPE RD STE B2
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-8258
Mailing Address - Country:US
Mailing Address - Phone:317-967-2229
Mailing Address - Fax:317-967-2229
Practice Address - Street 1:4609 GRAPE RD STE B2
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-8258
Practice Address - Country:US
Practice Address - Phone:317-967-2229
Practice Address - Fax:317-967-2229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health