Provider Demographics
NPI:1497353684
Name:HEALING ANGELS LLC
Entity Type:Organization
Organization Name:HEALING ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDOZILE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:917-974-5141
Mailing Address - Street 1:11474 225TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-1228
Mailing Address - Country:US
Mailing Address - Phone:516-303-0551
Mailing Address - Fax:
Practice Address - Street 1:1979 MARCUS AVE STE 210
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1022
Practice Address - Country:US
Practice Address - Phone:516-303-0551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty