Provider Demographics
NPI:1558941898
Name:PRECIOUS ANGELS PPEC INC.
Entity Type:Organization
Organization Name:PRECIOUS ANGELS PPEC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:W
Authorized Official - Last Name:HURBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-985-3484
Mailing Address - Street 1:217 W AVENUE A
Mailing Address - Street 2:
Mailing Address - City:BELLE GLADE
Mailing Address - State:FL
Mailing Address - Zip Code:33430-3019
Mailing Address - Country:US
Mailing Address - Phone:561-985-3484
Mailing Address - Fax:
Practice Address - Street 1:201 W AVENUE A
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-3019
Practice Address - Country:US
Practice Address - Phone:561-985-3484
Practice Address - Fax:561-992-4488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care