Provider Demographics
NPI:1356935423
Name:ANGELS COMMUNITY CARE SERVICES LLC
Entity type:Organization
Organization Name:ANGELS COMMUNITY CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NJINKENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-491-0829
Mailing Address - Street 1:6209 ERLAND WAY
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2481
Mailing Address - Country:US
Mailing Address - Phone:202-491-0829
Mailing Address - Fax:
Practice Address - Street 1:6209 ERLAND WAY
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2481
Practice Address - Country:US
Practice Address - Phone:202-491-0829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCNONEMedicaid