Provider Demographics
NPI:1548614860
Name:CALIBURN SERVICES, LLC
Entity Type:Organization
Organization Name:CALIBURN SERVICES, LLC
Other - Org Name:VISITING ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-408-9337
Mailing Address - Street 1:718 SW PORT ST LUCIE BLVD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-2689
Mailing Address - Country:US
Mailing Address - Phone:772-408-9337
Mailing Address - Fax:772-408-9336
Practice Address - Street 1:718 SW PORT ST LUCIE BLVD
Practice Address - Street 2:SUITE 7
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-2689
Practice Address - Country:US
Practice Address - Phone:772-408-9337
Practice Address - Fax:772-408-9336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994429253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care