Provider Demographics
NPI:1639827645
Name:ANGEL CARE COMPANION SERVICES
Entity Type:Organization
Organization Name:ANGEL CARE COMPANION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-480-4805
Mailing Address - Street 1:3611 COPLE HWY UNIT A
Mailing Address - Street 2:
Mailing Address - City:MONTROSS
Mailing Address - State:VA
Mailing Address - Zip Code:22520-3600
Mailing Address - Country:US
Mailing Address - Phone:804-480-4805
Mailing Address - Fax:
Practice Address - Street 1:3611 COPLE HWY UNIT A
Practice Address - Street 2:
Practice Address - City:MONTROSS
Practice Address - State:VA
Practice Address - Zip Code:22520-3600
Practice Address - Country:US
Practice Address - Phone:804-480-4805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care