Provider Demographics
NPI:1063958734
Name:ANGEL NURSING HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:ANGEL NURSING HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:O
Authorized Official - Last Name:FATUNGASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-277-3873
Mailing Address - Street 1:20358 MILL POND TER
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-6034
Mailing Address - Country:US
Mailing Address - Phone:240-277-3873
Mailing Address - Fax:
Practice Address - Street 1:921 RUSSELL AVE UNIT A
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3252
Practice Address - Country:US
Practice Address - Phone:240-277-3873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health