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Organization

DIVINE ANGEL SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DOMINICA CAMPOS (PRESIDENT)
(786) 316-5224
Entity
Organization

Contact information

Practice address
2265 SW 25TH ST, MIAMI, FL 33133-2323
(305) 388-0166
(305) 388-0565
Mailing address
2265 SW 25TH ST, MIAMI, FL 33133-2323
(305) 388-0166
(305) 388-0565

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
FSL000287901
FL
253Z00000X
In Home Supportive Care Agency
Primary
HCBS000287900
FL

Other

Enumeration date
09/05/2010
Last updated
09/05/2010
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