Provider Demographics
NPI:1669364279
Name:HIDDEN ANGELS HOMECARE
Entity type:Organization
Organization Name:HIDDEN ANGELS HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HIDDEN
Authorized Official - Middle Name:ANGELS HOME/DEMETRIA
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-305-4267
Mailing Address - Street 1:1203 N 27TH ST
Mailing Address - Street 2:RAYDEMETRIA@HOTMAIL.COM
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-6813
Mailing Address - Country:US
Mailing Address - Phone:402-305-4267
Mailing Address - Fax:
Practice Address - Street 1:1203 N 27TH ST
Practice Address - Street 2:RAYDEMETRIA@HOTMAIL.COM
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-1515
Practice Address - Country:US
Practice Address - Phone:402-305-4267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty