1295121051 NPI number — TOUCH BY AN ANGEL HOME CARE

Table of content: (NPI 1295121051)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295121051 NPI number — TOUCH BY AN ANGEL HOME CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOUCH BY AN ANGEL HOME CARE
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:
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:
1295121051
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5559 N STATE ROAD 7
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33319-2923
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-929-1901
Provider Business Mailing Address Fax Number:
561-961-4915

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5559 N STATE ROAD 7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33319-2923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-929-1901
Provider Business Practice Location Address Fax Number:
561-961-4915
Provider Enumeration Date:
04/08/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SIMPSON
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
561-419-3181

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 121943600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 016162500 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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