Provider Demographics
NPI:1215107685
Name:ANGELINE PRASHAD
Entity type:Organization
Organization Name:ANGELINE PRASHAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRASHAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-712-0913
Mailing Address - Street 1:4941 PINE CONE LN
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-4613
Mailing Address - Country:US
Mailing Address - Phone:561-712-0913
Mailing Address - Fax:561-712-0913
Practice Address - Street 1:4941 PINE CONE LN
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-4613
Practice Address - Country:US
Practice Address - Phone:561-712-0913
Practice Address - Fax:561-712-0913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-02
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10926310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility