Provider Demographics
NPI:1740844422
Name:ANGELA RENEE'S HOME CARE LLC
Entity type:Organization
Organization Name:ANGELA RENEE'S HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:KENNARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-445-0538
Mailing Address - Street 1:PO BOX 682334
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32868-2334
Mailing Address - Country:US
Mailing Address - Phone:847-445-0538
Mailing Address - Fax:800-479-9091
Practice Address - Street 1:2398 CORY CT
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761
Practice Address - Country:US
Practice Address - Phone:847-445-0538
Practice Address - Fax:800-479-9091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-27
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty