Healthcare Provider Details

I. General information

NPI: 1154903193
Provider Name (Legal Business Name): ANGEL WINGS HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 N MILITARY TRL STE C
WEST PALM BEACH FL
33409-2901
US

IV. Provider business mailing address

2215 N MILITARY TRL STE C
WEST PALM BEACH FL
33409-2901
US

V. Phone/Fax

Practice location:
  • Phone: 561-932-4665
  • Fax: 561-328-3932
Mailing address:
  • Phone: 561-932-4665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RESHMA HARILAL
Title or Position: OWNER
Credential:
Phone: 561-932-4665