Provider Demographics
NPI:1477002731
Name:CARING ANGELS OF VIRGINIA, LLC
Entity Type:Organization
Organization Name:CARING ANGELS OF VIRGINIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:BEATRICE
Authorized Official - Last Name:LOCKHART
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CSCM
Authorized Official - Phone:804-621-9722
Mailing Address - Street 1:4870 SADLER RD STE 300
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-6294
Mailing Address - Country:US
Mailing Address - Phone:888-264-3581
Mailing Address - Fax:804-368-7551
Practice Address - Street 1:13616 PROVIDENCE TRAIL CIR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-7481
Practice Address - Country:US
Practice Address - Phone:804-621-9722
Practice Address - Fax:804-368-7551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-171522251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health