Provider Demographics
NPI:1275009649
Name:ANGEL BLESS CARE SERVICE, LLC
Entity Type:Organization
Organization Name:ANGEL BLESS CARE SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CEZAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-479-6448
Mailing Address - Street 1:121 NE 29TH ST
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-3633
Mailing Address - Country:US
Mailing Address - Phone:954-479-6448
Mailing Address - Fax:
Practice Address - Street 1:121 NE 29TH ST
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3633
Practice Address - Country:US
Practice Address - Phone:954-479-6448
Practice Address - Fax:954-388-7252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child