# CUSTOM CARE OF ELLSWORTH, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Angels Care Home Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780600221
- **Authorized official:** MRS. ANGELA W EDDINS (PRESIDENT)
- **Authorized official phone:** (785) 445-3500

## Contact information

- **Practice address:** 802 N MAPLE ST, RUSSELL, KS 67665-1937
- **Practice address phone:** (785) 445-3500
- **Practice address fax:** (785) 445-3502
- **Mailing address:** 2301 HIGHWAY 1187, SUITE 203, MANSFIELD, TX 76063-6124
- **Mailing address phone:** (817) 469-6739

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | A027002 | KS | Yes |

## Other

- **Enumeration date:** 07/15/2006
- **Last updated:** 05/31/2018