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General NPI Number Information
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NPI Number | 1083853030
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Entity Type | Organization
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Legal Business Name | ANGELS ON LOAN, INC.
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Dates
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Enumeration Date | 02/16/2009
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Last Update Date | 02/16/2009
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Provider Practice Location Address
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Address Line | 4301 32ND ST W STE E27
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City | BRADENTON
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State | FL
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Zip | 34205-2713
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Country | US
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Telephone | 941-782-0752
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Fax | 941-782-0843
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Provider Business Mailing Address
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Address Line | 4301 32ND ST W STE E27
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City | BRADENTON
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State | FL
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Zip | 34205-2713
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Country | US
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Telephone | 941-782-0752
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Fax | 941-782-0843
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. FRANCES R BEURSKEN
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Credential | L.P.N.
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Telephone | 941-782-0752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 299993089
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License Number State | FL
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