Provider Demographics
NPI:1932634375
Name:ANGELIC HOMECARE LLC
Entity Type:Organization
Organization Name:ANGELIC HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICTORINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TANYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-779-8424
Mailing Address - Street 1:6319 CASTLE PL STE C
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-1907
Mailing Address - Country:US
Mailing Address - Phone:202-779-8424
Mailing Address - Fax:
Practice Address - Street 1:13800 COPPERMINE ROAD
Practice Address - Street 2:SUITE 175
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171
Practice Address - Country:US
Practice Address - Phone:202-779-8424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health