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General NPI Number Information
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NPI Number | 1437654563
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Entity Type | Organization
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Legal Business Name | ANGELIC HANDS HOME HEALTHCARE, LLC
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 202 BENTLEY ST
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City | TANEYTOWN
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State | MD
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Zip | 21787-2142
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Country | US
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Telephone | 443-201-6421
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Fax | 410-888-7198
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Provider Business Mailing Address
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Address Line | 202 BENTLEY ST
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City | TANEYTOWN
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State | MD
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Zip | 21787-2142
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Country | US
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Telephone | 443-201-6421
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Fax | 410-888-7198
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GIDEON BAYELLE
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Credential | MD
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Telephone | 410-888-7198
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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 | R4019
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License Number State | MD
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