Provider Demographics
NPI:1871250522
Name:KENNY'S ANGELS HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:KENNY'S ANGELS HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SENITA
Authorized Official - Middle Name:JANAE
Authorized Official - Last Name:BRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-752-6050
Mailing Address - Street 1:8831 MARINERS CV APT A
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-7753
Mailing Address - Country:US
Mailing Address - Phone:757-752-6050
Mailing Address - Fax:757-769-8391
Practice Address - Street 1:8831 MARINERS CV APT A
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23503-7753
Practice Address - Country:US
Practice Address - Phone:757-752-6050
Practice Address - Fax:757-769-8391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1598371924Medicaid