Provider Demographics
NPI:1093298200
Name:ANGELS OF KARING HEARTS LLC
Entity Type:Organization
Organization Name:ANGELS OF KARING HEARTS LLC
Other - Org Name:ANGELS OF KARING HEARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MGR
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DARVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-882-0233
Mailing Address - Street 1:2506 ACORN ST STE B
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34947-4750
Mailing Address - Country:US
Mailing Address - Phone:772-882-0233
Mailing Address - Fax:772-241-5931
Practice Address - Street 1:2506 ACORN ST STE B
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34947-4750
Practice Address - Country:US
Practice Address - Phone:772-882-0233
Practice Address - Fax:772-241-5931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL236936Medicaid
FL30212450Medicaid
FL43604OtherFLORIDA COMMUNITY CARE
FL2064984OtherWELLCARE #2064984
FL002465500Medicaid
FL93636OtherCNA