Angelic Hands Inc.

Organization Active NPI Home Health Agency · Cortez, CO

NPI 1619003894 · NPPES record last updated Jun 20, 2023

Key facts

NPI
1619003894
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
Legal business name
ANGELIC HANDS INC.
Practice address
343 E Main St
Cortez, CO 81321-3772
Phone
(970) 565-7134
Fax
(970) 565-9404
NPI assigned
Feb 24, 2007
Organization subpart
No

Authorized official

Name
Mrs. Diana O'Hara, RN
Title
Owner
Phone
(970) 565-7134

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Home health agency

Listed as
Guardian Angel Home Health CCN 067470
Overall star rating
★★☆☆☆ 1.5 of 5
Ownership
Proprietary
Certified
Aug 13, 2008
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Home health aide, Physical therapy, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Home health agency certification: CCN 067470

Legal name
ANGELIC HANDS INC.
Doing business as
GUARDIAN ANGEL HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 13, 2008
Last certification
Jan 17, 2020
Ownership / control type
Proprietary
Organization structure
Corporation · Proprietary
Incorporated
Jan 30, 2007 in NM
Enrollment address
343 E Main St
Cortez, CO 81321-3772
HHA Branch

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thomas J O Hara
Individual
5% Or Greater Direct Ownership Interest
Owner
Jan 30, 2007 50%
Corporate Officer
Cfo
Jan 30, 2007
Corporate Director
Cfo
Jan 30, 2007
W-2 Managing Employee
Cfo
Jan 30, 2007
Diana C Ohara
Individual
5% Or Greater Direct Ownership Interest
Owner
Jan 30, 2007 50%
Corporate Officer
President, Vice President
Jan 30, 2007
Corporate Director
President, Vice President
Jan 30, 2007
W-2 Managing Employee
Administrator
Jan 30, 2007

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070312000230 CO Part a Provider - Home Health Agency 6507969557 Practice locations: Cortez, CO

National Provider Directory

Tax ID family
Angelic Hands Inc (3 organizations share this tax ID)

Locations

343 E Main St
Cortez, CO 81321
Phone (970) 565-7134

925 S Broadway
Ste 286
Cortez, CO 81321
Phone (970) 565-7134

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Yes

Addresses

Primary practice location

343 E Main St
Cortez, CO 81321-3772

Mailing address

343 E Main St
Cortez, CO 81321-3772

Other identifiers

IdentifierTypeStateIssuer
9000142692MedicaidCO

Other names

  • Guardian Angel Home Health Doing business as

Other providers in Cortez, CO

All providers in Cortez, CO · Home Health Agency in Colorado

Sources for this page

Verify at the official NPI Registry.