Healthcare Provider Details

I. General information

NPI: 1295193951
Provider Name (Legal Business Name): HANDS OF ANGELS HEALTHCARE AGENCYLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2016
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 UNION AVE STE 503
IRVINGTON NJ
07111-3292
US

IV. Provider business mailing address

50 UNION AVE STE 503
IRVINGTON NJ
07111-3292
US

V. Phone/Fax

Practice location:
  • Phone: 973-900-9021
  • Fax:
Mailing address:
  • Phone: 973-900-9021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0215100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ERAINER ODOM
Title or Position: CEO
Credential:
Phone: 973-766-2800