Healthcare Provider Details

I. General information

NPI: 1922610369
Provider Name (Legal Business Name): LOVING ANGEL'S HEALTH CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 G ST NW STE 800
WASHINGTON DC
20005-6705
US

IV. Provider business mailing address

1200 G ST NW STE 800
WASHINGTON DC
20005-6705
US

V. Phone/Fax

Practice location:
  • Phone: 202-434-8710
  • Fax: 302-200-5543
Mailing address:
  • Phone: 202-434-8710
  • Fax: 302-200-5543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEMI KELLEY
Title or Position: OWNER/RN
Credential:
Phone: 703-338-8708