Provider Demographics
NPI:1962433896
Name:ANGEL HOME CARE SERVICES, INC.
Entity type:Organization
Organization Name:ANGEL HOME CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEGRE
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:305-220-4544
Mailing Address - Street 1:12955 SW 42ND ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-2920
Mailing Address - Country:US
Mailing Address - Phone:305-220-4544
Mailing Address - Fax:305-220-0061
Practice Address - Street 1:12955 SW 42ND ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-2920
Practice Address - Country:US
Practice Address - Phone:305-220-4544
Practice Address - Fax:305-220-0061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA22048096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650933900Medicaid
FL650933900Medicaid