Provider Demographics
NPI:1538323126
Name:ANGELS GARDEN 2
Entity Type:Organization
Organization Name:ANGELS GARDEN 2
Other - Org Name:ANGELS GARDEN LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUIRAND
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-806-0151
Mailing Address - Street 1:14017 BREEZE HILL LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-3051
Mailing Address - Country:US
Mailing Address - Phone:301-460-2328
Mailing Address - Fax:
Practice Address - Street 1:14017 BREEZE HILL LN
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-3051
Practice Address - Country:US
Practice Address - Phone:301-460-2328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANGELS GARDEN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15AL0385310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility