Provider Demographics
NPI:1457801896
Name:YOUR ANGELS, LLC
Entity Type:Organization
Organization Name:YOUR ANGELS, LLC
Other - Org Name:VISITING ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-241-6400
Mailing Address - Street 1:2215 CLUSTER OAK DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6772
Mailing Address - Country:US
Mailing Address - Phone:352-241-6400
Mailing Address - Fax:
Practice Address - Street 1:2215 CLUSTER OAK DR
Practice Address - Street 2:SUITE 3
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6772
Practice Address - Country:US
Practice Address - Phone:352-241-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211475253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care