Organization
ANGELIC PLACE HOME HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EMIGDUS L NKEM (DIRECTOR)
(571) 494-7066
Entity
Organization
Contact information
Practice address
754 WARRENTON RD STE 109, FREDERICKSBURG, VA 22406-1098
(540) 479-2756
(540) 642-4569
Mailing address
754 WARRENTON RD STE 109, FREDERICKSBURG, VA 22406-1098
(540) 479-2756
(540) 642-4569
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HCO-2088
—
VA
Enumeration date
03/18/2019
Last updated
03/18/2019
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