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General NPI Number Information
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NPI Number | 1629625579
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Entity Type | Organization
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Legal Business Name | VISIT BY AN ANGEL LLC
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Dates
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Enumeration Date | 08/23/2019
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Last Update Date | 02/05/2021
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Provider Practice Location Address
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Address Line | 124 SAINT JAMES AVE UNIT A1
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City | GOOSE CREEK
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State | SC
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Zip | 29445-2972
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Country | US
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Telephone | 843-584-3916
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Fax |
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Provider Business Mailing Address
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Address Line | 124 SAINT JAMES AVE UNIT A1
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City | GOOSE CREEK
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State | SC
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Zip | 29445-2972
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Country | US
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Telephone | 843-584-3916
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SHANI GEORGE
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Credential |
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Telephone | 843-584-3916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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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 | 332U00000X
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Taxonomy Name | Home Delivered Meals
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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 | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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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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