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General NPI Number Information
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NPI Number | 1912779422
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Entity Type | Organization
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Legal Business Name | MY ANGEL'S ADULT DAY CARE INC
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Dates
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Enumeration Date | 10/27/2023
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 130-160 SANTA BARBARA BLVD STE 102-103
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City | CAPE CORAL
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State | FL
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Zip | 33991
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Country | US
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Telephone | 239-306-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1104 NW 11TH PL
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City | CAPE CORAL
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State | FL
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Zip | 33993-6077
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Country | US
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Telephone | 239-306-2000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SIBYS CAMPOS
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Credential |
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Telephone | 239-306-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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