1962918102 NPI number — ANGEL MESSENGER HOME HEALTH AGENCY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962918102 NPI number — ANGEL MESSENGER HOME HEALTH AGENCY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANGEL MESSENGER HOME HEALTH AGENCY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962918102
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/26/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 421071
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KISSIMMEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34742-1071
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-781-6389
Provider Business Mailing Address Fax Number:
407-507-6254

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1802 CONCORD CIR APT H
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KISSIMMEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34741-3464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-781-6389
Provider Business Practice Location Address Fax Number:
407-507-6254
Provider Enumeration Date:
12/26/2017

Additional Information

Authorized Official

Authorized Official Last Name:
QUESTEL
Authorized Official First Name:
MARY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
407-781-6389

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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