Angel Gate Health Services LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

ANGEL GATE HEALTH SERVICES LLC

Practice address

12403 Hatchway CT
Woodbridge, VA 22192-2114

Phone

(240) 491-2868

NPI assigned

Jul 28, 2021

Organization subpart

No

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

Authorized official

Name

Charles Besong, DNPNPI 1720432172

Title

Director

Phone

(240) 491-2868

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Besong, RN, DNP, MSN, FNP-BC

  • Family Nurse Practitioner
  • Washington, DC
  • NPI 1720432172
  NPD Authorized official

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1417620212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12403 HATCHWAY CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922114",
            "telephone_number": "240-491-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12403 HATCHWAY CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922114",
            "telephone_number": "240-491-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL GATE HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "BESONG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "240-491-2868",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4397",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camille P Andrews
• Stephen Andrews, LCSW
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• Andy Anh the Ma DDS, PLLC
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• Bailey Angelino

• Developmentally Disabled Services Day Training Agency in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Developmentally Disabled Services Day Training Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.