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General NPI Number Information
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NPI Number | 1578290854
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Entity Type | Organization
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Legal Business Name | LATIN ANGELS FOR HOMECARE LLC.
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Dates
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Enumeration Date | 08/05/2022
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 199 AVENUE B NW STE 200-3
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City | WINTER HAVEN
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State | FL
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Zip | 33881-4546
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Country | US
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Telephone | 407-385-3470
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Fax | 407-610-6756
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Provider Business Mailing Address
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Address Line | 7619 COOT ST
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City | ORLANDO
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State | FL
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Zip | 32822-7705
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Country | US
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Telephone | 407-385-3470
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Fax | 407-610-6756
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Authorized Official
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Title or Position | CEO
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Name | PEDRO PENA CUESTA
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Credential |
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Telephone | 786-238-5632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 251B00000X
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Taxonomy Name | Case Management 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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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