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General NPI Number Information
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NPI Number | 1508783002
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Entity Type | Organization
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Legal Business Name | ANGEL CONCIERGE CARE LLC
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Dates
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Enumeration Date | 07/04/2026
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Last Update Date | 07/04/2026
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Provider Practice Location Address
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Address Line | 627 SW 3RD AVE
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-4701
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Country | US
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Telephone | 561-528-0629
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Fax |
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Provider Business Mailing Address
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Address Line | 627 SW 3RD AVE
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-4701
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Country | US
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Telephone | 561-528-0629
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | WADELINE DERILUS
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Credential | LPN
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Telephone | 561-528-0629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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