Organization
ANGEL STAR GROLUP HOME.INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ODALYS JIMENEZ (CEO)
(786) 389-4270
Entity
Organization
Contact information
Practice address
29791 SW 164TH CT, HOMESTEAD, FL 33033-3296
(786) 389-4270
Mailing address
29791 SW 164TH CT, HOMESTEAD, FL 33033-3296
(786) 389-4270
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/13/2026
Last updated
07/13/2026
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