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General NPI Number Information
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NPI Number | 1457923047
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Entity Type | Organization
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Legal Business Name | FAMILY OF ANGELS LLC
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 10004 ROSE PETAL PL
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City | RIVERVIEW
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State | FL
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Zip | 33578-4936
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Country | US
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Telephone | 813-445-3774
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Fax |
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Provider Business Mailing Address
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Address Line | 10004 ROSE PETAL PL
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City | RIVERVIEW
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State | FL
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Zip | 33578-4936
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Country | US
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Telephone | 813-445-3774
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | SHERMEKA L CARNEGIE
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Credential |
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Telephone | 813-445-3774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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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 | 347C00000X
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Taxonomy Name | Private Vehicle
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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 | 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 #4
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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 #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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