Provider Demographics
NPI:1609565761
Name:ARC ANGEL MRM HOME CARE SERVICES
Entity Type:Organization
Organization Name:ARC ANGEL MRM HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:P
Authorized Official - Last Name:MAGALLANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-647-0103
Mailing Address - Street 1:7109 KERR DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-3635
Mailing Address - Country:US
Mailing Address - Phone:703-647-0103
Mailing Address - Fax:
Practice Address - Street 1:7109 KERR DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-3635
Practice Address - Country:US
Practice Address - Phone:703-647-0103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty