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General NPI Number Information
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NPI Number | 1639478886
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Entity Type | Organization
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Legal Business Name | MEJC ANGELS LLC DBA VISITING ANGELS
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Dates
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Enumeration Date | 03/26/2011
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Last Update Date | 03/26/2011
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Provider Practice Location Address
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Address Line | 1931 NW 150TH AVE STE 123
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2873
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Country | US
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Telephone | 954-241-1048
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Fax | 954-281-8893
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Provider Business Mailing Address
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Address Line | 1931 NW 150TH AVE STE 123
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2873
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Country | US
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Telephone | 954-241-1048
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Fax | 954-281-8893
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Authorized Official
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Title or Position | DIRECTOR/CFO
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Name | EDITH CHARPENTIER
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Credential |
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Telephone | 954-241-1048
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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 | NR30211468
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License Number State | FL
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