Organization
ANGELS OF LOVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA T GUTIERREZ (CO-OWNER)
(262) 412-9052
Entity
Organization
Contact information
Practice address
422 MAIN ST STE 203, RACINE, WI 53403-1075
(262) 412-9052
(262) 536-4304
Mailing address
422 MAIN ST STE 203, RACINE, WI 53403-1075
(262) 412-9052
(262) 536-4304
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098287
—
WI
Enumeration date
09/02/2020
Last updated
09/02/2020
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