Organization
ANGELS OF LIGHT HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE RODRIGUEZ (MANAGER/OWNER)
(407) 416-5457
Entity
Organization
Contact information
Practice address
2704 NATURE VIEW RD, SAINT CLOUD, FL 34771-9330
(407) 416-5457
Mailing address
2704 NATURE VIEW RD, SAINT CLOUD, FL 34771-9330
(407) 416-5457
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
689577896
—
FL
Enumeration date
06/23/2022
Last updated
06/23/2022
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