Provider Demographics
NPI:1437650744
Name:TOUCHED BY AN ANGEL SENIOR CARE LLC
Entity Type:Organization
Organization Name:TOUCHED BY AN ANGEL SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-215-8803
Mailing Address - Street 1:12553 NEW BRITTANY BLVD BLDG 32
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3625
Mailing Address - Country:US
Mailing Address - Phone:239-215-8803
Mailing Address - Fax:239-313-6923
Practice Address - Street 1:12553 NEW BRITTANY BLVD BLDG 32
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3625
Practice Address - Country:US
Practice Address - Phone:239-215-8803
Practice Address - Fax:239-313-6923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL234475253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care