Provider Demographics
NPI:1619170834
Name:HANDS OF AN ANGEL HOME CARE AGENCY
Entity Type:Organization
Organization Name:HANDS OF AN ANGEL HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GEMMA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-486-7600
Mailing Address - Street 1:17 WARREN RD
Mailing Address - Street 2:SUITE 11B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5334
Mailing Address - Country:US
Mailing Address - Phone:410-486-7600
Mailing Address - Fax:410-486-8353
Practice Address - Street 1:17 WARREN RD
Practice Address - Street 2:SUITE 11B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-5334
Practice Address - Country:US
Practice Address - Phone:410-486-7600
Practice Address - Fax:410-486-8353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2084251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR2084OtherBUSINESS LICENSE NUMBER