Organization
ANGEL GROUP HOME CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETICIA PEREZ HERNANDEZ NURSE (PRESIDENT/OWNER)
(786) 355-6781
Entity
Organization
Contact information
Practice address
21321 SW 128TH CT, MIAMI, FL 33177-7421
(786) 355-6781
Mailing address
21321 SW 128TH CT, MIAMI, FL 33177-7421
(786) 355-6781
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/21/2015
Last updated
02/21/2015
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