Provider Demographics
NPI:1124556105
Name:ANGELIC ASSIST LLC
Entity Type:Organization
Organization Name:ANGELIC ASSIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TWANNA
Authorized Official - Middle Name:CHANNEL
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:202-819-8733
Mailing Address - Street 1:51 POE AVE STE A1
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-1552
Mailing Address - Country:US
Mailing Address - Phone:202-819-8733
Mailing Address - Fax:
Practice Address - Street 1:51 POE AVE STE A1
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-1552
Practice Address - Country:US
Practice Address - Phone:202-819-8733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-02
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health