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General NPI Number Information
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NPI Number | 1336499367
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Entity Type | Organization
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Legal Business Name | PRECIOUS ANGELS HOME CARE
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 18 N POLK AVE
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City | ARCADIA
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State | FL
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Zip | 34266
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Country | US
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Telephone | 863-491-8300
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Fax | 863-494-5350
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Provider Business Mailing Address
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Address Line | 5959 NW PETE COKERS LANDING
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City | ARCADIA
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State | FL
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Zip | 34266
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Country | US
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Telephone | 863-491-8300
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Fax | 863-494-5350
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Authorized Official
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Title or Position | CEO
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Name | LORI COKER
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Credential |
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Telephone | 863-990-1340
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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 | 230193
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License Number State | FL
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