Provider Demographics
NPI:1386971059
Name:LIVING ANGELS, LLC
Entity type:Organization
Organization Name:LIVING ANGELS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORJANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-280-8666
Mailing Address - Street 1:100 FULLER ST S
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-1348
Mailing Address - Country:US
Mailing Address - Phone:952-233-5600
Mailing Address - Fax:952-233-3226
Practice Address - Street 1:100 FULLER ST S
Practice Address - Street 2:SUITE 220
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-1348
Practice Address - Country:US
Practice Address - Phone:952-233-5600
Practice Address - Fax:952-233-3226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN346544251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health