MEDICARE: ANGEL HANDS HOME CARE SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	302R00000X	Health Maintenance Organization

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00007861	OTHER	MI	HOME HEALTH CARE

General Provider Information

NPI Number	:	1295960417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL HANDS HOME CARE SERVICES INC

Provider Business Mailing Address
First Line	:	5016 SILVERWOOD CT
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3372
Country	:	US
Telephone Number	:	248-854-0415
Fax Number	:	248-661-7812

Provider Business Practice Location Address
First Line	:	5016 SILVERWOOD CT
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3372
Country	:	US
Telephone Number	:	248-854-0415
Fax Number	:	248-661-7812

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MUHAMMAD KHURSHID SHAHAB
Credential	:	MANAGEMENT
Telephone Number	:	248-845-0415

Provider Enumeration Date	:	05/18/2009
Last Update Date	:	05/18/2009

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