Provider Demographics
NPI:1376105767
Name:MCANGEL HOME VISITING NURSES LLC
Entity Type:Organization
Organization Name:MCANGEL HOME VISITING NURSES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BERKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-605-3467
Mailing Address - Street 1:60 WASHINGTON AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3272
Mailing Address - Country:US
Mailing Address - Phone:203-691-6092
Mailing Address - Fax:203-486-8359
Practice Address - Street 1:60 WASHINGTON AVE STE 105
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3272
Practice Address - Country:US
Practice Address - Phone:203-691-6092
Practice Address - Fax:203-486-8359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-05
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health