Provider Demographics
NPI:1588472872
Name:BLOOMING ANGELS HEALTHCARE LLC
Entity type:Organization
Organization Name:BLOOMING ANGELS HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRITIONIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:ARROYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-508-4767
Mailing Address - Street 1:583 PARK WAY APT J
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-3659
Mailing Address - Country:US
Mailing Address - Phone:619-508-4767
Mailing Address - Fax:
Practice Address - Street 1:583 PARK WAY APT J
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3659
Practice Address - Country:US
Practice Address - Phone:619-508-4767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service