Organization
ANGEL GATE HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICODEMUS MORFAW (ADMINISTRATOR)
(202) 497-8947
Entity
Organization
Contact information
Practice address
12403 HATCHWAY CT, WOODBRIDGE, VA 22192-2114
(202) 497-8947
Mailing address
12403 HATCHWAY CT, WOODBRIDGE, VA 22192-2114
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/05/2018
Last updated
07/05/2018
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