Provider Demographics
NPI:1962664235
Name:PRECIOUS ANGELS HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:PRECIOUS ANGELS HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YILL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUZA,
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-285-3131
Mailing Address - Street 1:2470 NW 102 PLACE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1386
Mailing Address - Country:US
Mailing Address - Phone:305-285-3131
Mailing Address - Fax:
Practice Address - Street 1:2470 NW 102 PLACE
Practice Address - Street 2:SUITE 107
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1386
Practice Address - Country:US
Practice Address - Phone:305-285-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993066251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health