Provider Demographics
NPI:1437352168
Name:ANGELS IN PEACE
Entity Type:Organization
Organization Name:ANGELS IN PEACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-591-4083
Mailing Address - Street 1:5885 NW 214TH LANE
Mailing Address - Street 2:PO BOX 253
Mailing Address - City:MC INTOSH
Mailing Address - State:FL
Mailing Address - Zip Code:32664-0253
Mailing Address - Country:US
Mailing Address - Phone:352-591-4083
Mailing Address - Fax:352-591-1093
Practice Address - Street 1:5885 NW 214TH LANE
Practice Address - Street 2:
Practice Address - City:MC INTOSH
Practice Address - State:FL
Practice Address - Zip Code:32664-0253
Practice Address - Country:US
Practice Address - Phone:352-591-4083
Practice Address - Fax:352-591-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services