Provider Demographics
NPI:1457923047
Name:FAMILY OF ANGELS LLC
Entity type:Organization
Organization Name:FAMILY OF ANGELS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERMEKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARNEGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-445-3774
Mailing Address - Street 1:10004 ROSE PETAL PL
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4936
Mailing Address - Country:US
Mailing Address - Phone:813-445-3774
Mailing Address - Fax:
Practice Address - Street 1:10004 ROSE PETAL PL
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4936
Practice Address - Country:US
Practice Address - Phone:813-445-3774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child