Provider Demographics
NPI:1174039499
Name:ANGELIC HOME CARE OF SARASOTA
Entity Type:Organization
Organization Name:ANGELIC HOME CARE OF SARASOTA
Other - Org Name:ANGELIC HOME CARE OF SARASOTA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MEHWISH
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-323-0700
Mailing Address - Street 1:5070 CENTRAL SARASOTA PKWY
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-7605
Mailing Address - Country:US
Mailing Address - Phone:941-323-0700
Mailing Address - Fax:
Practice Address - Street 1:5070 CENTRAL SARASOTA PKWY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-7605
Practice Address - Country:US
Practice Address - Phone:941-323-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-22
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL39969932253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care