Healthcare Provider Details

I. General information

NPI: 1841799715
Provider Name (Legal Business Name): BEDSIDE ANGEL'S HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 E EISENHOWER PKWY STE 300
ANN ARBOR MI
48108-3324
US

IV. Provider business mailing address

455 E EISENHOWER PKWY STE 300
ANN ARBOR MI
48108-3324
US

V. Phone/Fax

Practice location:
  • Phone: 734-678-6957
  • Fax: 734-270-2146
Mailing address:
  • Phone: 734-678-6957
  • Fax: 734-270-2146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CRYSTAL RENEE LEE
Title or Position: FOUNDER/OWNER
Credential:
Phone: 734-678-6957