Provider Demographics
NPI:1427539915
Name:ANGELS 4 ANGELS, INC
Entity Type:Organization
Organization Name:ANGELS 4 ANGELS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAVIS
Authorized Official - Middle Name:WELLINGTON
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-337-0047
Mailing Address - Street 1:3300 WESTERN BRANCH BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5145
Mailing Address - Country:US
Mailing Address - Phone:757-337-0047
Mailing Address - Fax:757-337-0649
Practice Address - Street 1:3300 WESTERN BRANCH BLVD STE B
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5145
Practice Address - Country:US
Practice Address - Phone:757-337-0047
Practice Address - Fax:757-337-0649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1487132676Medicaid
VA1487143160Medicaid