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General NPI Number Information
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NPI Number | 1114416872
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Entity Type | Organization
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Legal Business Name | DOROTHY'S ANGELS, LLC
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 3190 SEDONA TRL
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City | JACKSONVILLE
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State | FL
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Zip | 32208
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Country | US
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Telephone | 904-798-0282
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Fax |
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Provider Business Mailing Address
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Address Line | 3190 SEDONA TRL
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City | JACKSONVILLE
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State | FL
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Zip | 32208-8441
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Country | US
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Telephone | 904-798-0282
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CRYSTAL TRAMAINE SIMMONS
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Credential | LPN
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Telephone | 904-894-8386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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