Provider Demographics
NPI:1124461470
Name:ANGELS WE CARE
Entity type:Organization
Organization Name:ANGELS WE CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILFRID
Authorized Official - Middle Name:
Authorized Official - Last Name:DECOSSARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-918-2748
Mailing Address - Street 1:20 LEDGE LN
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-3319
Mailing Address - Country:US
Mailing Address - Phone:203-918-2748
Mailing Address - Fax:
Practice Address - Street 1:20 LEDGE LN
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-3319
Practice Address - Country:US
Practice Address - Phone:203-918-2748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0000751253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT153718Medicaid