Healthcare Provider Details

I. General information

NPI: 1881145753
Provider Name (Legal Business Name): BLESSED ANGELS HOME HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2016
Last Update Date: 12/16/2022
Certification Date: 12/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9470 ANNAPOLIS RD STE 208
LANHAM MD
20706-3083
US

IV. Provider business mailing address

9470 ANNAPOLIS RD STE 208
LANHAM MD
20706-3083
US

V. Phone/Fax

Practice location:
  • Phone: 301-390-4400
  • Fax: 301-578-2514
Mailing address:
  • Phone: 301-390-4400
  • Fax: 301-576-4588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberR3682
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: FRANCISCA LAWSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 301-390-4400