Provider Demographics
NPI:1558349498
Name:ANGEL ARMS
Entity Type:Organization
Organization Name:ANGEL ARMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-854-8101
Mailing Address - Street 1:PO BOX 4758
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-4758
Mailing Address - Country:US
Mailing Address - Phone:352-854-8101
Mailing Address - Fax:352-861-6375
Practice Address - Street 1:1109 SE 33RD AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2927
Practice Address - Country:US
Practice Address - Phone:352-854-8101
Practice Address - Fax:352-861-6375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL229402251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL68347019Medicaid