Provider Demographics
NPI:1831418656
Name:ANGEL NURSING HOMECARE, INC.
Entity type:Organization
Organization Name:ANGEL NURSING HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PRIYANKA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOSLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-864-6617
Mailing Address - Street 1:9508 CLAYCHIN CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-4187
Mailing Address - Country:US
Mailing Address - Phone:703-864-6617
Mailing Address - Fax:703-636-5766
Practice Address - Street 1:9508 CLAYCHIN CT
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-4187
Practice Address - Country:US
Practice Address - Phone:703-864-6617
Practice Address - Fax:703-636-5766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient