Provider Demographics
NPI:1558133538
Name:ACTIVE ANGELS HOMECARE
Entity type:Organization
Organization Name:ACTIVE ANGELS HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONIECE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-317-8505
Mailing Address - Street 1:8474 DONNA LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-1833
Mailing Address - Country:US
Mailing Address - Phone:513-317-8505
Mailing Address - Fax:
Practice Address - Street 1:8474 DONNA LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-1833
Practice Address - Country:US
Practice Address - Phone:513-317-8505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health