Provider Demographics
NPI:1063057065
Name:ANGEL LOVE HOME CAREGIVERS
Entity type:Organization
Organization Name:ANGEL LOVE HOME CAREGIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:P
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-713-2146
Mailing Address - Street 1:301 ANDOVER PL S APT 172
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-5938
Mailing Address - Country:US
Mailing Address - Phone:412-713-2146
Mailing Address - Fax:
Practice Address - Street 1:301 ANDOVER PL S APT 172
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5938
Practice Address - Country:US
Practice Address - Phone:412-713-2146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty