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General NPI Number Information
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NPI Number | 1912345034
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Entity Type | Organization
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Legal Business Name | ANGELS TCH INC
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Dates
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Enumeration Date | 06/11/2013
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 11207 COCOA BEACH DR
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City | RIVERVIEW
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State | FL
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Zip | 33569-2949
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Country | US
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Telephone | 813-416-6810
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Fax |
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Provider Business Mailing Address
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Address Line | 202 BUTLER AVE STE 306
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City | LANCASTER
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State | PA
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Zip | 17601-6306
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Country | US
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Telephone | 888-566-4201
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Fax | 888-597-2332
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VELMA DAVIS-SCOTT
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Credential |
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Telephone | 813-416-6810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 12347
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License Number State | FL
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