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General NPI Number Information
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NPI Number | 1184183311
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Entity Type | Organization
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Legal Business Name | ANGELIC PLACE HOME HEALTH LLC
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 754 WARRENTON RD STE 109
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City | FREDERICKSBURG
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State | VA
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Zip | 22406-1098
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Country | US
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Telephone | 540-479-2756
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Fax | 540-642-4569
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Provider Business Mailing Address
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Address Line | 754 WARRENTON RD STE 109
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City | FREDERICKSBURG
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State | VA
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Zip | 22406-1098
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Country | US
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Telephone | 540-479-2756
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Fax | 540-642-4569
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. EMIGDUS L NKEM
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Credential |
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Telephone | 571-494-7066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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