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General NPI Number Information
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NPI Number | 1932634375
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Entity Type | Organization
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Legal Business Name | ANGELIC HOMECARE LLC
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Dates
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Enumeration Date | 04/24/2017
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 13800 COPPERMINE ROAD SUITE 175
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City | HERNDON
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State | VA
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Zip | 20171
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Country | US
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Telephone | 202-779-8424
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Fax |
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Provider Business Mailing Address
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Address Line | 6319 CASTLE PL STE C
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City | FALLS CHURCH
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State | VA
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Zip | 22044-1907
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Country | US
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Telephone | 202-779-8424
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VICTORINE TANYI
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Credential |
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Telephone | 202-779-8424
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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 |
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