Organization
ANGELS UNIQUE LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY W PERGERSON (DIRECTOR)
(352) 523-1111
Entity
Organization
Contact information
Practice address
13520 17TH ST, DADE CITY, FL 33525-5211
(352) 523-1111
(352) 523-1122
Mailing address
13520 17TH ST, DADE CITY, FL 33525-5211
(352) 523-1111
(352) 523-1122
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
FL
253Z00000X
In Home Supportive Care Agency
230477
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001856800
—
FL
05
—
680166801
—
FL
05
—
680166896
—
FL
05
—
680166898
—
FL
Enumeration date
12/15/2010
Last updated
12/15/2010
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