Healthcare Provider Details

I. General information

NPI: 1073417382
Provider Name (Legal Business Name): ANGELIC ANGELS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2704 BELLVIEW AVE
PENSACOLA FL
32526-1365
US

IV. Provider business mailing address

2704 BELLVIEW AVE
PENSACOLA FL
32526-1365
US

V. Phone/Fax

Practice location:
  • Phone: 850-341-3315
  • Fax:
Mailing address:
  • Phone: 850-341-3315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. MEYATA SHANTE YOUNG
Title or Position: OWNER
Credential: CNA
Phone: 850-341-3315