Healthcare Provider Details

I. General information

NPI: 1205368388
Provider Name (Legal Business Name): VISITING ANGELS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 03/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106-E GALLOWS RD
VIENNA VA
22182
US

IV. Provider business mailing address

2106-E GALLOWS RD
VIENNA VA
22182
US

V. Phone/Fax

Practice location:
  • Phone: 703-291-1262
  • Fax: 703-291-4974
Mailing address:
  • Phone: 703-291-1262
  • Fax: 703-291-4974

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 Code305S00000X
TaxonomyPoint of Service
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MARIE GINA PANGLE
Title or Position: DIRECTOR
Credential:
Phone: 703-291-1262