Healthcare Provider Details

I. General information

NPI: 1427280387
Provider Name (Legal Business Name): TOUCH OF AN ANGEL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2009
Last Update Date: 08/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 FOX HILL RD
HAMPTON VA
23669-2309
US

IV. Provider business mailing address

102 FOX HILL RD
HAMPTON VA
23669-2309
US

V. Phone/Fax

Practice location:
  • Phone: 757-771-7280
  • Fax:
Mailing address:
  • Phone: 757-771-7280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number376G00000
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHAZ COOPER DISLY
Title or Position: CEO/PRESIEDNT
Credential:
Phone: 757-771-7280