Provider Demographics
NPI:1285091488
Name:HEAVENS ANGELS HOME HEALTH CARE AGENCY LLC
Entity type:Organization
Organization Name:HEAVENS ANGELS HOME HEALTH CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:TEACRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-960-4402
Mailing Address - Street 1:129 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-2717
Mailing Address - Country:US
Mailing Address - Phone:877-531-2921
Mailing Address - Fax:475-204-3415
Practice Address - Street 1:5 BENNITT ST STE B5
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-2780
Practice Address - Country:US
Practice Address - Phone:860-960-4402
Practice Address - Fax:866-506-7517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health