Healthcare Provider Details

I. General information

NPI: 1104415108
Provider Name (Legal Business Name): AV HEALING HANDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2021
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7307 BALTIMORE AVE STE 108B
COLLEGE PARK MD
20740-3231
US

IV. Provider business mailing address

7307 BALTIMORE AVE STE 108B
COLLEGE PARK MD
20740-3231
US

V. Phone/Fax

Practice location:
  • Phone: 240-375-1670
  • Fax: 202-946-5904
Mailing address:
  • Phone: 240-375-1670
  • Fax: 202-946-4923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ANGELIQUE LYNETTE VAILES
Title or Position: OWNER
Credential:
Phone: 240-375-1670