# ANGELIC PLACE HOME HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184183311
- **Authorized official:** MR. EMIGDUS L NKEM (DIRECTOR)
- **Authorized official phone:** (571) 494-7066

## Contact information

- **Practice address:** 754 WARRENTON RD STE 109, FREDERICKSBURG, VA 22406-1098
- **Practice address phone:** (540) 479-2756
- **Practice address fax:** (540) 642-4569
- **Mailing address:** 754 WARRENTON RD STE 109, FREDERICKSBURG, VA 22406-1098
- **Mailing address phone:** (540) 479-2756
- **Mailing address fax:** (540) 642-4569

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | — | Yes |
| 251J00000X | Nursing Care Agency | — | — | — |
| 253Z00000X | In Home Supportive Care Agency | — | — | — |

## Other

- **Enumeration date:** 03/18/2019
- **Last updated:** 03/18/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | HCO-2088 | — | VA |