Provider Demographics
NPI:1659749752
Name:ANGELS FOR KIDS ON-CALL
Entity Type:Organization
Organization Name:ANGELS FOR KIDS ON-CALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGMENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:IVETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROSA
Authorized Official - Suffix:
Authorized Official - Credentials:BA, PSYCHOLOGY
Authorized Official - Phone:407-791-0109
Mailing Address - Street 1:7550 FUTURE DRIVE SUITE 105
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819
Mailing Address - Country:US
Mailing Address - Phone:407-730-7983
Mailing Address - Fax:
Practice Address - Street 1:7550 FUTURE DRIVE SUITE 105
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:407-730-7983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management