Healthcare Provider Details

I. General information

NPI: 1073027140
Provider Name (Legal Business Name): CARE ANGELS HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CORPORATE DR STE 301
STAFFORD VA
22554-4889
US

IV. Provider business mailing address

2650 JEFFERSON DAVIS HWY UNIT 522
STAFFORD VA
22555-3622
US

V. Phone/Fax

Practice location:
  • Phone: 877-788-2880
  • Fax: 877-904-3069
Mailing address:
  • Phone: 888-788-2880
  • Fax: 877-904-3069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NANA BOATENG
Title or Position: PRESIDENT
Credential:
Phone: 888-788-2880