NPIMap

Organization Active NPI

Angelic Home Care LLC

  • In Home Supportive Care Agency
  • Waterbury, CT
National Provider Identifier
1750107868
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
ANGELIC HOME CARE LLC
Practice address
3029 N Main St
Waterbury, CT 06704-1214
Phone
(203) 982-3834
NPI assigned
Nov 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Authorized official

Name
Dr. Charles J. O. Kodi, DR
Title
Ceo/Co-Owner
Phone
(203) 982-3834

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

3029 N Main St
Waterbury, CT 06704-1214

Mailing address

85 Phyllis Ave
Waterbury, CT 06708-3613
Phone (203) 982-3834

Other names 1

  • ANGELIC HOME CARE Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1750107868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 PHYLLIS AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083613",
            "telephone_number": "203-982-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3029 N MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067041214",
            "telephone_number": "203-982-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELIC HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "KODI",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J. O.",
        "authorized_official_title_or_position": "CEO/CO-OWNER",
        "authorized_official_telephone_number": "203-982-3834",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DR"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ANGELIC HOME CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ANGELIC HOME CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.