Healthcare Provider Details

I. General information

NPI: 1083974786
Provider Name (Legal Business Name): ANGELINA MANGA HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2012
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 GREENBELT RD STE M6
BERWYN HEIGHTS MD
20740-2358
US

IV. Provider business mailing address

7001 96TH AVE
LANHAM MD
20706-3615
US

V. Phone/Fax

Practice location:
  • Phone: 240-550-6035
  • Fax: 301-972-0901
Mailing address:
  • Phone: 202-545-0935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP1047443
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1047443
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: