Provider Demographics
NPI:1851556039
Name:BLUE ANGELS HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:BLUE ANGELS HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LEEA
Authorized Official - Middle Name:LORAINE
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:1866-503-4321
Mailing Address - Street 1:2167 MOHEGAN DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2512
Mailing Address - Country:US
Mailing Address - Phone:186-650-3432
Mailing Address - Fax:
Practice Address - Street 1:2167 MOHEGAN DR
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2512
Practice Address - Country:US
Practice Address - Phone:186-650-3432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-27
Last Update Date:2008-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0851644251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health