Provider Demographics
NPI:1679162671
Name:AV HEALING HANDS, LLC
Entity Type:Organization
Organization Name:AV HEALING HANDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELIQUE
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:VAILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-375-1670
Mailing Address - Street 1:7307 BALTIMORE AVE STE 108B
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-3231
Mailing Address - Country:US
Mailing Address - Phone:240-452-0027
Mailing Address - Fax:202-946-5904
Practice Address - Street 1:7307 BALTIMORE AVE STE 108B
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-3231
Practice Address - Country:US
Practice Address - Phone:240-452-0027
Practice Address - Fax:202-946-5904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty