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General NPI Number Information
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NPI Number | 1487140992
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Entity Type | Organization
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Legal Business Name | ANGEL WINGS CARE SERVICES
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Dates
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Enumeration Date | 07/09/2018
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 3280 RIVERMONT DR
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City | FRONT ROYAL
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State | VA
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Zip | 22630-8224
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Country | US
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Telephone | 540-323-1561
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Fax | 540-409-5262
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Provider Business Mailing Address
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Address Line | 3280 RIVERMONT DR
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City | FRONT ROYAL
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State | VA
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Zip | 22630-8224
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Country | US
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Telephone | 540-323-1561
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Fax | 540-409-5262
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | DARRELL CALLIS
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Credential | M.ED, QMHP
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Telephone | 540-323-1561
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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 | HCO-1570
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | HCO-1570
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO-1570
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License Number State | VA
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