Provider Demographics
NPI:1710350483
Name:ANGELCARE 365
Entity Type:Organization
Organization Name:ANGELCARE 365
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANTE
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:443-939-1001
Mailing Address - Street 1:1607 RUTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-2414
Mailing Address - Country:US
Mailing Address - Phone:443-939-1001
Mailing Address - Fax:410-276-1063
Practice Address - Street 1:1607 RUTLAND AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-2414
Practice Address - Country:US
Practice Address - Phone:443-939-1001
Practice Address - Fax:410-276-1063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No385H00000XRespite Care FacilityRespite Care