Provider Demographics
NPI:1609128032
Name:ANGEL 'S CARE AGENCY
Entity Type:Organization
Organization Name:ANGEL 'S CARE AGENCY
Other - Org Name:ANGEL'S CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAGDALA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLEUS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:203-543-2206
Mailing Address - Street 1:1266 E.MAIN ST SUITE 700R
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902
Mailing Address - Country:US
Mailing Address - Phone:203-543-2206
Mailing Address - Fax:
Practice Address - Street 1:1266 E MAIN ST STE 700R
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3550
Practice Address - Country:US
Practice Address - Phone:203-543-2206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT082961251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care