Angels of Love LLC

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Legal business name

ANGELS OF LOVE LLC

Practice address

422 Main St Ste 203
Racine, WI 53403-1075

Phone

(262) 412-9052

Fax

(262) 536-4304

NPI assigned

Sep 2, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tara T Gutierrez

Title

Co-Owner

Phone

(262) 412-9052

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1639783129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 MAIN ST STE 203",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031075",
            "telephone_number": "262-412-9052",
            "fax_number": "262-536-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 MAIN ST STE 203",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031075",
            "telephone_number": "262-412-9052",
            "fax_number": "262-536-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELS OF LOVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "262-412-9052"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098287",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Racine",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "422 Main St Ste 203",
            "city": "Racine",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534031075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.