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General NPI Number Information
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NPI Number | 1033462197
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Entity Type | Organization
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Legal Business Name | NURSING CARE BY ANGELS
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 8085 BABCOCK ST SE
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City | PALM BAY
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State | FL
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Zip | 32909-5910
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Country | US
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Telephone | 321-345-4774
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Fax | 321-914-0712
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Provider Business Mailing Address
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Address Line | 8085 BABCOCK ST SE
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City | PALM BAY
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State | FL
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Zip | 32909-5910
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Country | US
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Telephone | 321-345-4774
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Fax | 321-914-0712
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CORALIE PRINCE
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Credential | RN
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Telephone | 321-299-7687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL12241
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License Number State | FL
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