Provider Demographics
NPI:1134724883
Name:STANFORD ANGELS LLC
Entity type:Organization
Organization Name:STANFORD ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:STANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-944-6727
Mailing Address - Street 1:190 STATE ROUTE 27 STE 101
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3538
Mailing Address - Country:US
Mailing Address - Phone:862-944-6727
Mailing Address - Fax:
Practice Address - Street 1:190 STATE ROUTE 27 STE 101
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3538
Practice Address - Country:US
Practice Address - Phone:862-944-6727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health