Earth Angels Health & Wellness, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

EARTH ANGELS HEALTH & WELLNESS, LLC

Practice address

10177 Lancashire Dr
Jacksonville, FL 32219-4367

Phone

(904) 729-5242

Fax

(904) 765-3155

NPI assigned

Oct 11, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lega K Long, MS

Title

Owner/Ceo

Phone

(904) 729-5242

Specialties & licenses 1

Addresses

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665446400000",
    "number": "1184349185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28585",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322268585",
            "telephone_number": "904-729-5242",
            "fax_number": "904-765-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10177 LANCASHIRE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322194367",
            "telephone_number": "904-729-5242",
            "fax_number": "904-765-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARTH ANGELS HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "LEGA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "904-729-5242",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LEGA@EARTHANGELSWELLNESS.COM",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10177 Lancashire Dr",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322194367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.