Provider Demographics
NPI:1083853030
Name:ANGELS ON LOAN, INC.
Entity Type:Organization
Organization Name:ANGELS ON LOAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEURSKEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:941-782-0752
Mailing Address - Street 1:4301 32ND ST W STE E27
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-2713
Mailing Address - Country:US
Mailing Address - Phone:941-782-0752
Mailing Address - Fax:941-782-0843
Practice Address - Street 1:4301 32ND ST W STE E27
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-2713
Practice Address - Country:US
Practice Address - Phone:941-782-0752
Practice Address - Fax:941-782-0843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-16
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993089251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health