Provider Demographics
NPI:1639298573
Name:ANGEL LOVING CARE INC
Entity Type:Organization
Organization Name:ANGEL LOVING CARE INC
Other - Org Name:ANGEL LOVING CARE RESIDENTIAL AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FATIATU
Authorized Official - Middle Name:
Authorized Official - Last Name:JOBI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-937-0188
Mailing Address - Street 1:4715 SELLMAN RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-2571
Mailing Address - Country:US
Mailing Address - Phone:301-937-0188
Mailing Address - Fax:301-937-1466
Practice Address - Street 1:4715 SELLMAN RD
Practice Address - Street 2:SUITE D
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2571
Practice Address - Country:US
Practice Address - Phone:301-937-0188
Practice Address - Fax:301-937-1466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2329251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health