Provider Demographics
NPI:1427280387
Name:TOUCH OF AN ANGEL, INC
Entity type:Organization
Organization Name:TOUCH OF AN ANGEL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIEDNT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAZ
Authorized Official - Middle Name:COOPER
Authorized Official - Last Name:DISLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-771-7280
Mailing Address - Street 1:102 FOX HILL RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-2309
Mailing Address - Country:US
Mailing Address - Phone:757-771-7280
Mailing Address - Fax:
Practice Address - Street 1:102 FOX HILL RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-2309
Practice Address - Country:US
Practice Address - Phone:757-771-7280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X, 305S00000X
VA376G00000314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No305S00000XManaged Care OrganizationsPoint of Service
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility