Healthcare Provider Details

I. General information

NPI: 1275731549
Provider Name (Legal Business Name): CARING ANGELS ON GUARD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 12/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W ALFRED ST
TAVARES FL
32778-3205
US

IV. Provider business mailing address

PO BOX 88
TAVARES FL
32778-0088
US

V. Phone/Fax

Practice location:
  • Phone: 352-346-5855
  • Fax: 352-729-2508
Mailing address:
  • Phone: 352-346-5855
  • Fax: 352-729-2508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number233036
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number008951900
License Number StateFL

VIII. Authorized Official

Name: MRS. FELECIA MICHELLE FREEMAN
Title or Position: OWNER
Credential: RN
Phone: 352-346-5855