Provider Demographics
NPI:1689338790
Name:ANGELS WITH OPEN ARMS LLC
Entity Type:Organization
Organization Name:ANGELS WITH OPEN ARMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:KEYONDA
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:CMT, MA
Authorized Official - Phone:301-364-7426
Mailing Address - Street 1:716 PAREV WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1690
Mailing Address - Country:US
Mailing Address - Phone:301-364-7426
Mailing Address - Fax:301-686-0709
Practice Address - Street 1:716 PAREV WAY
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1690
Practice Address - Country:US
Practice Address - Phone:301-364-7426
Practice Address - Fax:301-686-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No347C00000XTransportation ServicesPrivate VehicleGroup - Single Specialty