Healthcare Provider Details

I. General information

NPI: 1093439234
Provider Name (Legal Business Name): ANGELS MISSION HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2022
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 WILLOW GLEN CT
STAFFORD VA
22554-8208
US

IV. Provider business mailing address

46 WILLOW GLEN CT
STAFFORD VA
22554-8208
US

V. Phone/Fax

Practice location:
  • Phone: 240-547-7651
  • Fax: 540-720-1001
Mailing address:
  • Phone: 240-547-7651
  • Fax: 540-720-1001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: HENRY KIGGUNDU LUKWAGO
Title or Position: OWNER
Credential:
Phone: 770-630-5620