MEDICARE: ULTIMATE ANGELS HOME HEALTHCARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	299992917	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558550871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTIMATE ANGELS HOME HEALTHCARE INC

Provider Business Mailing Address
First Line	:	1873 W WOOLBRIGHT RD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-6321
Country	:	US
Telephone Number	:	561-461-7211
Fax Number	:	561-461-7212

Provider Business Practice Location Address
First Line	:	1873 W WOOLBRIGHT RD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-6321
Country	:	US
Telephone Number	:	561-461-7211
Fax Number	:	561-461-7212

Authorized Official
Title or Position	:	ADMISTRATOR
Name	:	NADEGE SAINT JUSTE
Credential	:
Telephone Number	:	561-461-7211

Provider Enumeration Date	:	10/23/2007
Last Update Date	:	11/12/2021

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