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General NPI Number Information
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NPI Number | 1952180093
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Entity Type | Organization
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Legal Business Name | PEGS TV ANGELS
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Dates
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Enumeration Date | 09/27/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 13940 N US HIGHWAY 441 STE 204
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City | LADY LAKE
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State | FL
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Zip | 32159-8909
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Country | US
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Telephone | 352-643-0702
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Fax | 352-633-1134
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Provider Business Mailing Address
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Address Line | 13940 N US HIGHWAY 441 STE 204
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City | LADY LAKE
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State | FL
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Zip | 32159-8909
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Country | US
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Telephone | 352-643-0702
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Fax | 352-633-1134
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MARGARET PICKETT
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Credential |
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Telephone | 352-643-0702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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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 | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #4
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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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