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General NPI Number Information
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NPI Number | 1982199196
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Entity Type | Organization
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Legal Business Name | ANGEL PREFERRED HOME CARE LLC
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Dates
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Enumeration Date | 06/29/2018
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Last Update Date | 06/29/2018
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Provider Practice Location Address
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Address Line | 501 GOODLETTE RD N STE 18
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City | NAPLES
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State | FL
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Zip | 34102-5661
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Country | US
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Telephone | 239-263-0441
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Fax |
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Provider Business Mailing Address
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Address Line | 501 GOODLETTE RD N STE D100
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City | NAPLES
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State | FL
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Zip | 34102-5666
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Country | US
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Telephone | 239-263-0441
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Fax | 239-263-4407
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | WILFRID THERESIAS
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Credential |
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Telephone | 239-263-0441
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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 | 299994669
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License Number State | FL
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