Provider Demographics
NPI:1427461094
Name:ANGELS RECOVERY LLC
Entity type:Organization
Organization Name:ANGELS RECOVERY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOVAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:JASPERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-795-0018
Mailing Address - Street 1:11576 PIERSON RD
Mailing Address - Street 2:SUITE K4
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8767
Mailing Address - Country:US
Mailing Address - Phone:561-721-4142
Mailing Address - Fax:561-721-4151
Practice Address - Street 1:11576 PIERSON RD
Practice Address - Street 2:SUITE K4
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-8767
Practice Address - Country:US
Practice Address - Phone:561-721-4142
Practice Address - Fax:561-721-4151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25378291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory