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General NPI Number Information
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NPI Number | 1922501394
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Entity Type | Organization
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Legal Business Name | GRANTED ANGELS INC
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Dates
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Enumeration Date | 03/13/2018
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 2860 HIGHWAY 71 STE B
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City | MARIANNA
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State | FL
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Zip | 32446-1893
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Country | US
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Telephone | 850-209-4238
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Fax | 888-979-8559
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Provider Business Mailing Address
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Address Line | 6783 ROCKY LN
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City | GRAND RIDGE
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State | FL
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Zip | 32442-4219
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Country | US
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Telephone | 850-209-4238
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Fax | 850-592-2604
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Authorized Official
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Title or Position | CEO
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Name | MRS. BRANDY GRANT
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Credential |
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Telephone | 850-209-4238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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