Provider Demographics
NPI:1477701050
Name:WB&LC,LLC
Entity Type:Organization
Organization Name:WB&LC,LLC
Other - Org Name:VISITING ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENIFER
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BONOLLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-797-8600
Mailing Address - Street 1:944 4TH ST N
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-1735
Mailing Address - Country:US
Mailing Address - Phone:727-797-8600
Mailing Address - Fax:727-822-3037
Practice Address - Street 1:944 4TH ST N
Practice Address - Street 2:SUITE 700
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-1735
Practice Address - Country:US
Practice Address - Phone:727-797-8600
Practice Address - Fax:727-822-3037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211274251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL693177400OtherMEDICAID WAIVER