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General NPI Number Information
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NPI Number | 1184904021
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Entity Type | Organization
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Legal Business Name | ANGEL'S WINGS OF LOVE, INC
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Dates
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Enumeration Date | 08/24/2011
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Last Update Date | 08/24/2011
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Provider Practice Location Address
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Address Line | 910 S ADELLE AVE SUITE B
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City | DELAND
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State | FL
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Zip | 32720-7326
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Country | US
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Telephone | 386-960-6504
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3891
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City | DELAND
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State | FL
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Zip | 32721-3891
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Country | US
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Telephone | 386-960-6504
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Fax |
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Authorized Official
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Title or Position | PRESIDENT-OWNER
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Name | MRS. JOY BRINSON
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Credential |
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Telephone | 386-631-8197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 003813600
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 003813600
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License Number State | FL
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