Healthcare Provider Details

I. General information

NPI: 1972008951
Provider Name (Legal Business Name): ANGELS OF LOVE HOMEMAKER & COMPANION SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 07/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2808 GRIFFIN RD
LEESBURG FL
34748-3209
US

IV. Provider business mailing address

PO BOX 493832
LEESBURG FL
34749-3832
US

V. Phone/Fax

Practice location:
  • Phone: 352-875-1041
  • Fax: 352-431-3747
Mailing address:
  • Phone: 352-875-1041
  • Fax: 352-365-0271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: SHARON JEFFRIES
Title or Position: OWNER
Credential: HOME HEALTH
Phone: 352-875-1041