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General NPI Number Information
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NPI Number | 1952933392
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Entity Type | Organization
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Legal Business Name | CHARLIE'S ANGELS CARE AT HOME, LLC
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Dates
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Enumeration Date | 02/04/2020
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 2600 MEMORIAL AVE STE 102
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City | LYNCHBURG
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State | VA
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Zip | 24501-2658
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Country | US
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Telephone | 434-439-2138
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 MEMORIAL AVE STE 102
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City | LYNCHBURG
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State | VA
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Zip | 24501-2658
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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 | ADMINISTRATOR
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Name | MELISSA CARTER
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Credential |
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Telephone | 434-401-8667
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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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