Provider Demographics
NPI:1629422209
Name:SENIOR CARE ANGELS
Entity Type:Organization
Organization Name:SENIOR CARE ANGELS
Other - Org Name:VISITING ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIKKI
Authorized Official - Middle Name:
Authorized Official - Last Name:KALITSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-583-8820
Mailing Address - Street 1:9701 APOLLO DR
Mailing Address - Street 2:SUITE 297
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4783
Mailing Address - Country:US
Mailing Address - Phone:301-583-8820
Mailing Address - Fax:301-583-8768
Practice Address - Street 1:9701 APOLLO DR
Practice Address - Street 2:SUITE 297
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4783
Practice Address - Country:US
Practice Address - Phone:301-583-8820
Practice Address - Fax:301-583-8768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2077253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care