Provider Demographics
NPI:1528777257
Name:ANGELS TCH INC
Entity type:Organization
Organization Name:ANGELS TCH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS-SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-532-7767
Mailing Address - Street 1:11216 MCMULLEN RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-6310
Mailing Address - Country:US
Mailing Address - Phone:813-416-6810
Mailing Address - Fax:
Practice Address - Street 1:11216 MCMULLEN RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-6310
Practice Address - Country:US
Practice Address - Phone:813-416-6810
Practice Address - Fax:831-850-6633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility