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General NPI Number Information
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NPI Number | 1063958734
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Entity Type | Organization
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Legal Business Name | ANGEL NURSING HEALTH CARE SERVICES LLC
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Dates
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Enumeration Date | 01/18/2017
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 921 RUSSELL AVE UNIT A
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City | GAITHERSBURG
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State | MD
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Zip | 20879-3252
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Country | US
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Telephone | 240-277-3873
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Fax |
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Provider Business Mailing Address
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Address Line | 20358 MILL POND TER
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City | GERMANTOWN
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State | MD
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Zip | 20876-6034
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Country | US
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Telephone | 240-277-3873
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Fax |
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Authorized Official
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Title or Position | DON
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Name | FLORENCE O FATUNGASE
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Credential |
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Telephone | 240-277-3873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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