Healthcare Provider Details

I. General information

NPI: 1336009299
Provider Name (Legal Business Name): ANGEL WINGS LUXURY HOME CARE GROUP LLC DBA ANGEL WINGS LUXURY HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17790 MONTAGE
CLINTON TOWNSHIP MI
48038-3804
US

IV. Provider business mailing address

17790 MONTAGE
CLINTON TOWNSHIP MI
48038-3804
US

V. Phone/Fax

Practice location:
  • Phone: 407-655-7065
  • Fax:
Mailing address:
  • Phone: 407-655-7065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: EVELYN MARIE WHITTAKER
Title or Position: CEO
Credential:
Phone: 407-655-7065