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General NPI Number Information
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NPI Number | 1427280387
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Entity Type | Organization
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Legal Business Name | TOUCH OF AN ANGEL, INC
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Dates
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Enumeration Date | 08/11/2009
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 102 FOX HILL RD
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City | HAMPTON
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State | VA
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Zip | 23669-2309
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Country | US
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Telephone | 757-771-7280
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Fax |
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Provider Business Mailing Address
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Address Line | 102 FOX HILL RD
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City | HAMPTON
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State | VA
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Zip | 23669-2309
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Country | US
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Telephone | 757-771-7280
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIEDNT
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Name | MR. CHAZ COOPER DISLY
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Credential |
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Telephone | 757-771-7280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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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 | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 376G00000
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License Number State | VA
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Taxonomy #3
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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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