Provider Demographics
NPI:1063180677
Name:ANDREA'S ANGELS, INC.
Entity type:Organization
Organization Name:ANDREA'S ANGELS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-854-8783
Mailing Address - Street 1:117 CHURCH AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218
Mailing Address - Country:US
Mailing Address - Phone:718-854-8783
Mailing Address - Fax:
Practice Address - Street 1:3819 SAINT VRAIN ST STE D
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:CO
Practice Address - Zip Code:80620-2600
Practice Address - Country:US
Practice Address - Phone:718-854-8783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health