Organization
ANGELS UNAWARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROSS HOLTEN OBANION JR. (EXECUTIVE DIRECTOR)
(813) 961-1159
Entity
Organization
Contact information
Practice address
4918 W LINEBAUGH AVENUE, TAMPA, FL 33624-5028
(813) 961-1159
(813) 265-1656
Mailing address
PO BOX 270040, TAMPA, FL 33688-0040
(813) 961-1159
(813) 265-1656
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024115696
APB
FL
05
—
024115696
—
FL
Enumeration date
01/17/2007
Last updated
03/15/2011
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