Provider Demographics
NPI:1821407875
Name:ANGEL CARE, INC.
Entity Type:Organization
Organization Name:ANGEL CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIAVSKAIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-507-7500
Mailing Address - Street 1:485 KINGS HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1809
Mailing Address - Country:US
Mailing Address - Phone:917-507-7500
Mailing Address - Fax:
Practice Address - Street 1:485 KINGS HWY STE 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1809
Practice Address - Country:US
Practice Address - Phone:917-507-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05274295Medicaid