Provider Demographics
NPI:1639478886
Name:MEJC ANGELS LLC DBA VISITING ANGELS
Entity Type:Organization
Organization Name:MEJC ANGELS LLC DBA VISITING ANGELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CFO
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARPENTIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-241-1048
Mailing Address - Street 1:1931 NW 150TH AVE STE 123
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2873
Mailing Address - Country:US
Mailing Address - Phone:954-241-1048
Mailing Address - Fax:954-281-8893
Practice Address - Street 1:1931 NW 150TH AVE STE 123
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2873
Practice Address - Country:US
Practice Address - Phone:954-241-1048
Practice Address - Fax:954-281-8893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-26
Last Update Date:2011-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNR30211468251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health