Provider Demographics
NPI:1215221247
Name:PRESENCES OF ANGELS
Entity Type:Organization
Organization Name:PRESENCES OF ANGELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:239-284-8876
Mailing Address - Street 1:3748 RICHARD RD.
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT
Mailing Address - State:FL
Mailing Address - Zip Code:33903
Mailing Address - Country:US
Mailing Address - Phone:239-284-8876
Mailing Address - Fax:
Practice Address - Street 1:3748 RICHARD RD
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-3725
Practice Address - Country:US
Practice Address - Phone:239-284-8876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care