Provider Demographics
NPI:1629625579
Name:VISIT BY AN ANGEL LLC
Entity Type:Organization
Organization Name:VISIT BY AN ANGEL LLC
Other - Org Name:VISIT BY AN ANGEL HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANI
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-584-3916
Mailing Address - Street 1:124 SAINT JAMES AVE UNIT A1
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-2972
Mailing Address - Country:US
Mailing Address - Phone:843-584-3916
Mailing Address - Fax:
Practice Address - Street 1:124 SAINT JAMES AVE UNIT A1
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-2972
Practice Address - Country:US
Practice Address - Phone:843-584-3916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No332U00000XSuppliersHome Delivered Meals
No385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child