# ANGELIC HEART AT HOME CARE

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

## Provider details

- **NPI number:** 1255756714
- **Authorized official:** CLOTILDE FLORES (ADMINISTRATOR/PRESIDENT)
- **Authorized official phone:** (571) 330-6228

## Contact information

- **Practice address:** 3022 JAVIER RD STE 207A, FAIRFAX, VA 22031-4657
- **Practice address phone:** (703) 560-6100
- **Practice address fax:** (703) 560-6101
- **Mailing address:** 3022 JAVIER RD STE 207A, FAIRFAX, VA 22031-4657
- **Mailing address phone:** (703) 560-6100
- **Mailing address fax:** (703) 560-6101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | VA | Yes |

## Other

- **Enumeration date:** 02/20/2014
- **Last updated:** 02/20/2014