Healthcare Provider Details

I. General information

NPI: 1811296734
Provider Name (Legal Business Name): GROWING ANGELS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2011
Last Update Date: 03/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26917 SOUTH DIXIE HIGHWAY
NARANJA FL
33032-7715
US

IV. Provider business mailing address

13530 SW 267TH ST
NARANJA FL
33032-7715
US

V. Phone/Fax

Practice location:
  • Phone: 786-234-4520
  • Fax: 786-349-5562
Mailing address:
  • Phone: 786-234-4520
  • Fax: 786-349-5562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. TINA LOUISE ALI
Title or Position: FOUNDER/DIRECTOR
Credential: N/A
Phone: 786-234-4520