Three Angels Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THREE ANGELS ASSISTED LIVING LLC

Practice address

1012 Ivy LN
Waldorf, MD 20602-1900

Phone

(240) 467-7434

Fax

(301) 645-1507

NPI assigned

May 17, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Andrea Easy

Title

Assisted Living Manager

Phone

(240) 467-7434

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1063261337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 IVY LN",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021900",
            "telephone_number": "240-467-7434",
            "fax_number": "301-645-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 IVY LN",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021900",
            "telephone_number": "240-467-7434",
            "fax_number": "301-645-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE ANGELS ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "EASY",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "ASSISTED LIVING MANAGER",
        "authorized_official_telephone_number": "240-467-7434",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Assisted Living Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.