Provider Demographics
NPI:1336499367
Name:PRECIOUS ANGELS HOME CARE
Entity Type:Organization
Organization Name:PRECIOUS ANGELS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-990-1340
Mailing Address - Street 1:5959 NW PETE COKERS LANDING
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266
Mailing Address - Country:US
Mailing Address - Phone:863-491-8300
Mailing Address - Fax:863-494-5350
Practice Address - Street 1:18 N POLK AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266
Practice Address - Country:US
Practice Address - Phone:863-491-8300
Practice Address - Fax:863-494-5350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230193251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health