Organization
GLORIAS ANGELS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES HENRY RAFFERTY JR. (AGENT)
(904) 318-5275
Entity
Organization
Contact information
Practice address
5615 VILLAGE POND CIR, JACKSONVILLE, FL 32222-1159
(904) 318-5275
Mailing address
5615 VILLAGE POND CIR, JACKSONVILLE, FL 32222-1159
(904) 318-5275
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
08/07/2017
Last updated
07/21/2022
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