Provider Demographics
NPI:1326427949
Name:BLESSED ANGELS HOME HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:BLESSED ANGELS HOME HEALTHCARE SERVICES LLC
Other - Org Name:BLESSED ANGELS NURSING AND THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCA
Authorized Official - Middle Name:ISIMEME
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-390-4400
Mailing Address - Street 1:9470 ANNAPOLIS RD STE 208
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3083
Mailing Address - Country:US
Mailing Address - Phone:301-390-4400
Mailing Address - Fax:301-576-4588
Practice Address - Street 1:9470 ANNAPOLIS RD STE 208
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3083
Practice Address - Country:US
Practice Address - Phone:301-390-4400
Practice Address - Fax:301-576-4588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3682251E00000X
251J00000X, 3140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD423315800OtherCOMMUNITY FIRST CHOICE
MD423314000Medicaid