Healthcare Provider Details

I. General information

NPI: 1134698442
Provider Name (Legal Business Name): VILLAGE OF ANGELS HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 JAMES STREET SUITE 007
NEW HAVEN CT
06513
US

IV. Provider business mailing address

470 JAMES STREET SUITE 007
NEW HAVEN CT
06513
US

V. Phone/Fax

Practice location:
  • Phone: 866-782-6435
  • Fax:
Mailing address:
  • Phone: 866-782-6435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: JILLIAN TITUS
Title or Position: CEO/CO-OWNER
Credential: LPN
Phone: 866-782-6435