# CHARLIES ANGELS HOME HEALTHCARE LLC

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

## Provider details

- **NPI number:** 1558969717
- **Authorized official:** LANIQUE T. BASS (AIDE)
- **Authorized official phone:** (419) 810-5438

## Contact information

- **Practice address:** 500 MADISON AVE STE 310, TOLEDO, OH 43604-1230
- **Practice address phone:** (419) 810-5438
- **Practice address fax:** (541) 635-5779
- **Mailing address:** 744 GENEVA AVE, TOLEDO, OH 43609-2950
- **Mailing address phone:** (419) 810-5438

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/10/2020
- **Last updated:** 05/09/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0413187 | — | OH |