# LITTLE ANGELS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437495041
- **Authorized official:** MRS. LISA CRUZ RN (OWNER)
- **Authorized official phone:** (208) 346-2222

## Contact information

- **Practice address:** 1680 WOODRUFF PARK, IDAHO FALLS, ID 83401-3330
- **Practice address phone:** (208) 346-2222
- **Mailing address:** 1680 WOODRUFF PARK, IDAHO FALLS, ID 83401-3330
- **Mailing address phone:** (208) 346-2222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | N38708 | ID | — |
| 2084P0800X | Psychiatry Physician | M9188 | ID | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | M9188 | ID | — |
| 363A00000X | Physician Assistant | PA334 | ID | Yes |

## Other

- **Enumeration date:** 12/31/2012
- **Last updated:** 04/17/2013