Provider Demographics
NPI:1194986059
Name:ANGELS IN PARADISE
Entity type:Organization
Organization Name:ANGELS IN PARADISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAGALY
Authorized Official - Middle Name:B
Authorized Official - Last Name:TRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-818-9666
Mailing Address - Street 1:4636 W 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3802
Mailing Address - Country:US
Mailing Address - Phone:305-818-9666
Mailing Address - Fax:305-818-9666
Practice Address - Street 1:4636 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3802
Practice Address - Country:US
Practice Address - Phone:305-818-9666
Practice Address - Fax:305-818-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL102963104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness