Provider Demographics
NPI:1528362787
Name:ANGEL AIDS CENTER
Entity Type:Organization
Organization Name:ANGEL AIDS CENTER
Other - Org Name:BOYNTON BEACH ALF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:RAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMRUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-737-6465
Mailing Address - Street 1:1708 NE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-2501
Mailing Address - Country:US
Mailing Address - Phone:561-737-6465
Mailing Address - Fax:561-737-7925
Practice Address - Street 1:1708 NE 4TH ST
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-2501
Practice Address - Country:US
Practice Address - Phone:561-737-6465
Practice Address - Fax:561-737-7925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5799310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility