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General NPI Number Information
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NPI Number | 1316419740
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Entity Type | Organization
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Legal Business Name | ANGELS MISSION HOME CARE SERVICES LLC
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Dates
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Enumeration Date | 12/25/2018
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 46 WILLOW GLEN CT
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City | STAFFORD
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State | VA
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Zip | 22554-8208
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Country | US
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Telephone | 540-720-1006
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Fax | 540-720-1001
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Provider Business Mailing Address
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Address Line | 1951 GABLERIDGE TURN APT 303
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City | WOODBRIDGE
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State | VA
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Zip | 22191-1974
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Country | US
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Telephone | 240-547-7651
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Fax |
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Authorized Official
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Title or Position | BSN-RN
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Name | HENRY K LUKWAGO
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Credential | ADMINISTRATOR
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Telephone | 240-547-7651
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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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