Provider Demographics
NPI:1770309122
Name:4 ANGELS HOME HEALTHCARE, LLC
Entity type:Organization
Organization Name:4 ANGELS HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZADRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-495-9260
Mailing Address - Street 1:16213 OWL EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-6537
Mailing Address - Country:US
Mailing Address - Phone:202-495-9260
Mailing Address - Fax:
Practice Address - Street 1:16213 OWL EAGLE CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-6537
Practice Address - Country:US
Practice Address - Phone:202-495-9260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child