Healthcare Provider Details

I. General information

NPI: 1770497513
Provider Name (Legal Business Name): MARYS ANGELS HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 N COURSE DR APT 203
POMPANO BEACH FL
33069-3000
US

IV. Provider business mailing address

2809 N COURSE DR APT 203
POMPANO BEACH FL
33069-3000
US

V. Phone/Fax

Practice location:
  • Phone: 954-950-6046
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL

VIII. Authorized Official

Name: JANAY WHITE
Title or Position: OWNER
Credential:
Phone: 954-950-6046