ANGEL OF LIGHT ASSISTED LIVING FACILITY, LLC (NPI# 1760967590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760967590 |
| Entity Type | Organization |
| Organization Name | ANGEL OF LIGHT ASSISTED LIVING FACILITY, LLC |
| Practice Address |
613 Sw Homeland Rd Port St Lucie FL 34953-6263 |
| Practice Telephone | 7723535885 |
| Practice Fax Number | 7723535890 |
| Mailing Telephone | 7723535885 |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2018-09-27 |
| Authorized Official Name | MS. ISOLYN BISHOP (ADMINISTRATOR) |
| Authorized Official Telephone | 7725010144 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Street Address |
613 SW HOMELAND RD |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34953-6263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033733720 | Paul Desantis | Optometrist | 1805 Gatlin Blvd, Port St. Lucie, FL 34953 | 2020-05-29 |
| 1174165997 | D&r Homehealthcare LLC | Technician | 1210 Southwest Santiago Avenue, Port Saint Lucie, Fl, FL 34953 | 2019-10-14 |
| 1023677630 | Physical Therapy Wellness Group | Clinic/Center | 519 Sw Nagle Place, Port Saint Lucie, FL 34953 | 2019-06-07 |
| 1063993699 | Bloom Firm, LLC | Home Health | 1714 Sw Cycle St, Port Saint Lucie, FL 34953 | 2018-08-22 |
| 1386121333 | For His Glory Alf LLC. | Assisted Living Facility | 322 Sw South Quick Circle, Port St Lucie, FL 34953 | 2018-07-23 |
| 1730670555 | Susan May Thyme | Nurse Practitioner | 1762 Sw Choate St, Port Saint Lucie, FL 34953 | 2018-05-29 |
| 1164911301 | Viven Banks | Counselor | 3581 Sw Kromrey St, Port Saint Lucie, FL 34953 | 2018-05-03 |
| 1205323441 | Katherine Monroig | Behavior Technician | 4557 Se Babylon St, Port Saint Lucie, FL 34953 | 2018-04-13 |
| 1528567583 | Roger Rene Trudel | Nurse Practitioner | 3686 Sw Carmody Street, Port St Lucie, FL 34953 | 2018-02-06 |
| 1801315502 | Metushela Nicolas | Adult Companion | 1112 Jennifer Ter, Port Saint Lucie, FL 34953 | 2017-09-13 |
| Find all providers in zip 34953 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811597404 | Huguette Mortimer Dupont | Assisted Living Facility | 1596 Sw Paar Dr, Port St Lucie, FL 34953-6159 | 2020-11-01 |
| 1952947228 | Savorah Alf II | Assisted Living Facility | 2369 Sw Fern Cir, Port St Lucie, FL 34953-2951 | 2019-11-21 |
| 1598224669 | Blessings Assisted Living | Assisted Living Facility | 2449 Sw Humber Ct, Port St Lucie, FL 34953-2133 | 2019-03-18 |
| 1427517762 | Springfield Gardens Group Home | Assisted Living Facility | 443 Sw Homeland Rd, Port St Lucie, FL 34953-6208 | 2019-03-17 |
| 1285104463 | Caring Assisted Living, LLC | Assisted Living Facility | 2588 Sw Grotto Cir, Port St Lucie, FL 34953-2926 | 2018-11-29 |
| 1386121333 | For His Glory Alf LLC. | Assisted Living Facility | 322 Sw South Quick Circle, Port St Lucie, FL 34953 | 2018-07-23 |
| 1033696232 | New Dimension Family Care Inc. | Assisted Living Facility | 849 Sw Hamberland Ave, Port St Lucie, FL 34953-5629 | 2018-07-20 |
| 1659857001 | Heavenly Adult Care LLC | Assisted Living Facility | 3934 Sw Kakopo St, Port St Lucie, FL 34953-3631 | 2018-07-18 |
| 1336635796 | Avalon Family Resort Assisted Living | Assisted Living Facility | 160 Sw Saratoga Ave, Port St Lucie, FL 34953-5977 | 2018-07-09 |
| 1083100440 | Loving Care of The Treasure Coast II, LLC | Assisted Living Facility | 1816 Sw Brisbane St, Port St Lucie, FL 34984-3507 | 2018-07-09 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34953 |
Please comment or provide details below to improve the information on ANGEL OF LIGHT ASSISTED LIVING FACILITY, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.