Provider Demographics
NPI:1952180093
Name:PEGS TV ANGELS
Entity Type:Organization
Organization Name:PEGS TV ANGELS
Other - Org Name:VISITING ANGELS OF THE VILLAGES AND SURROUNDING AREAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-643-0702
Mailing Address - Street 1:13940 N US HIGHWAY 441 STE 204
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-8909
Mailing Address - Country:US
Mailing Address - Phone:352-643-0702
Mailing Address - Fax:352-633-1134
Practice Address - Street 1:13940 N US HIGHWAY 441 STE 204
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-8909
Practice Address - Country:US
Practice Address - Phone:352-643-0702
Practice Address - Fax:352-633-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty