Organization
LOVING ANGELS ASSISTED LIVING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TERESA GOMEZ (ADMINISTRATOR/OWNER)
(917) 582-2393
Entity
Organization
Contact information
Practice address
9 RAMBLE WAY, PALM COAST, FL 32164-8800
(917) 582-2393
Mailing address
77B BRUNSWICK LN, PALM COAST, FL 32137-3627
(917) 582-2393
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12405
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010584200
—
FL
Enumeration date
10/17/2016
Last updated
10/17/2016
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