Healthcare Provider Details

I. General information

NPI: 1851850283
Provider Name (Legal Business Name): ANGELS IN CHARGE HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 03/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 WILLIAM ST
STRATFORD CT
06614-4734
US

IV. Provider business mailing address

104 WILLIAM ST
STRATFORD CT
06614-4734
US

V. Phone/Fax

Practice location:
  • Phone: 202-386-0055
  • Fax:
Mailing address:
  • Phone: 202-386-0055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: BEULAH LEE WALLACE
Title or Position: MEMBER
Credential:
Phone: 203-386-0055