Provider Demographics
NPI:1336579671
Name:ANGELIC COMPANION SERVICES, LLC
Entity Type:Organization
Organization Name:ANGELIC COMPANION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-747-3073
Mailing Address - Street 1:12472 LAKE UNDERHILL RD # 323
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7144
Mailing Address - Country:US
Mailing Address - Phone:407-747-3073
Mailing Address - Fax:407-512-4524
Practice Address - Street 1:498 PALM SPRINGS DR STE 100
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-7849
Practice Address - Country:US
Practice Address - Phone:407-747-3073
Practice Address - Fax:407-512-4524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-23
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health