Organization
MARY'S CARING ANGELS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELVIN IVIA GAINES JR. (PRESIDENT)
(352) 502-2938
Entity
Organization
Contact information
Practice address
915 SW FORT KING ST, OCALA, FL 34471-1503
(352) 502-2938
Mailing address
915 SW FORT KING ST, OCALA, FL 34471-1503
(352) 502-2938
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023658000
—
FL
Enumeration date
06/20/2020
Last updated
06/20/2020
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