Provider Demographics
NPI:1811583529
Name:NANA'S HOME ANGELS LLC
Entity Type:Organization
Organization Name:NANA'S HOME ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAYLAND
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-922-7621
Mailing Address - Street 1:140 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-1147
Mailing Address - Country:US
Mailing Address - Phone:860-922-7621
Mailing Address - Fax:
Practice Address - Street 1:548 NEW BRITAIN AVE APT 3
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-4068
Practice Address - Country:US
Practice Address - Phone:860-922-7621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health