Provider Demographics
NPI:1326330275
Name:ANGEL LIFE CARE, LLC
Entity Type:Organization
Organization Name:ANGEL LIFE CARE, LLC
Other - Org Name:BRIGHTSTAR OF WEST PALM BEACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:P
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-360-0528
Mailing Address - Street 1:560 ROYAL PALM BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-7677
Mailing Address - Country:US
Mailing Address - Phone:561-383-6967
Mailing Address - Fax:561-628-0256
Practice Address - Street 1:560 ROYAL PALM BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-7677
Practice Address - Country:US
Practice Address - Phone:561-383-6967
Practice Address - Fax:561-628-0256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health