Healthcare Provider Details

I. General information

NPI: 1669349627
Provider Name (Legal Business Name): ANGEL HANDS TO HEARTS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 BOXELDER DR
STAFFORD VA
22554-6865
US

IV. Provider business mailing address

170 BOXELDER DR
STAFFORD VA
22554-6865
US

V. Phone/Fax

Practice location:
  • Phone: 571-579-9586
  • Fax: 571-579-9586
Mailing address:
  • Phone: 571-579-9586
  • Fax: 571-579-9586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: OUAFA DAMERJI
Title or Position: OWNER
Credential:
Phone: 571-579-9586