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General NPI Number Information
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NPI Number | 1891156428
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Entity Type | Organization
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Legal Business Name | VISITING ANGELS HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 03/09/2016
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Last Update Date | 03/09/2016
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Provider Practice Location Address
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Address Line | 514 FRANKLIN AVE
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City | CHERRY HILL
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State | NJ
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Zip | 08002-2939
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Country | US
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Telephone | 240-486-5392
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Fax |
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Provider Business Mailing Address
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Address Line | 545 NEWTON LAKE DR APT C328
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City | COLLINGSWOOD
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State | NJ
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Zip | 08107-7614
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARIE NICOLE TATUM
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Credential |
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Telephone | 240-486-5392
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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 | NJ
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