Healthcare Provider Details

I. General information

NPI: 1639478886
Provider Name (Legal Business Name): MEJC ANGELS LLC DBA VISITING ANGELS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2011
Last Update Date: 03/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1931 NW 150TH AVE STE 123
PEMBROKE PINES FL
33028-2873
US

IV. Provider business mailing address

1931 NW 150TH AVE STE 123
PEMBROKE PINES FL
33028-2873
US

V. Phone/Fax

Practice location:
  • Phone: 954-241-1048
  • Fax: 954-281-8893
Mailing address:
  • Phone: 954-241-1048
  • Fax: 954-281-8893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberNR30211468
License Number StateFL

VIII. Authorized Official

Name: EDITH CHARPENTIER
Title or Position: DIRECTOR/CFO
Credential:
Phone: 954-241-1048