Provider Demographics
NPI:1851610943
Name:GLORIA'S ANGELS HOME HEALTH CARE
Entity type:Organization
Organization Name:GLORIA'S ANGELS HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEWEL
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-673-4407
Mailing Address - Street 1:3300 HIGH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3321
Mailing Address - Country:US
Mailing Address - Phone:757-673-4407
Mailing Address - Fax:757-673-4432
Practice Address - Street 1:3300 HIGH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3321
Practice Address - Country:US
Practice Address - Phone:757-673-4407
Practice Address - Fax:757-673-4432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management