Provider Demographics
NPI:1710135587
Name:ANGELS HOME CARE AGENCY, INC.
Entity Type:Organization
Organization Name:ANGELS HOME CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAN JUAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-732-7588
Mailing Address - Street 1:3600 S STATE ROAD 7 STE 14
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5288
Mailing Address - Country:US
Mailing Address - Phone:954-966-0320
Mailing Address - Fax:954-966-0321
Practice Address - Street 1:3600 S STATE ROAD 7
Practice Address - Street 2:STE 14
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5289
Practice Address - Country:US
Practice Address - Phone:954-966-0320
Practice Address - Fax:954-966-0321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993463251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health