Provider Demographics
NPI:1942809918
Name:ANGEL HEART HOMEMAKER AND COMPANION CARE SERVICES LLC
Entity Type:Organization
Organization Name:ANGEL HEART HOMEMAKER AND COMPANION CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISMAELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-470-1259
Mailing Address - Street 1:1510 HANCOCK BRIDGE PKWY STE 1
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1715
Mailing Address - Country:US
Mailing Address - Phone:239-599-4192
Mailing Address - Fax:239-800-3134
Practice Address - Street 1:1510 HANCOCK BRIDGE PKWY STE 1
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-1715
Practice Address - Country:US
Practice Address - Phone:239-599-4192
Practice Address - Fax:239-800-3134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care