1255836284 NPI number — ANGELS HELPING HANDS, LLC

Table of content: LEAH SAMARIA JONES LCSW (NPI 1417664558)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255836284 NPI number — ANGELS HELPING HANDS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANGELS HELPING HANDS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255836284
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8942 QUIOCCASIN RD STE 104
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENRICO
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23229-5534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-238-1378
Provider Business Mailing Address Fax Number:
800-861-9684

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8942 QUIOCCASIN RD STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENRICO
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23229-5534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-238-1378
Provider Business Practice Location Address Fax Number:
800-861-9684
Provider Enumeration Date:
03/30/2018

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
VERONICA
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
MANAGING OWNER-FACILITATOR
Authorized Official Telephone Number:
804-238-1378

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X , with the licence number:  0242308994 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0242308994 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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