Provider Demographics
NPI:1730348665
Name:THE ANGELS GARDEN LLC
Entity type:Organization
Organization Name:THE ANGELS GARDEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANIE
Authorized Official - Middle Name:ANTOINE
Authorized Official - Last Name:GUIRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-806-0151
Mailing Address - Street 1:4101 BEL PRE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-2002
Mailing Address - Country:US
Mailing Address - Phone:301-460-0304
Mailing Address - Fax:
Practice Address - Street 1:4101 BEL PRE RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-2002
Practice Address - Country:US
Practice Address - Phone:301-460-0304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ANGELS GARDEN 2
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-05
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15AL0350310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility