Provider Demographics
NPI:1083862387
Name:HOME FOR THE ANGELS
Entity Type:Organization
Organization Name:HOME FOR THE ANGELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ORDOVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-488-7587
Mailing Address - Street 1:9270 SW 42 TERRA
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165
Mailing Address - Country:US
Mailing Address - Phone:305-207-4481
Mailing Address - Fax:305-820-0335
Practice Address - Street 1:9270 SW 42 TERRA
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165
Practice Address - Country:US
Practice Address - Phone:305-207-4481
Practice Address - Fax:305-820-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9648310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility