Healthcare Provider Details

I. General information

NPI: 1598554263
Provider Name (Legal Business Name): ANGELS ANGELIC HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22451 HAYNES AVE
FARMINGTON HILLS MI
48336-4336
US

IV. Provider business mailing address

22451 HAYNES AVE
FARMINGTON HILLS MI
48336-4336
US

V. Phone/Fax

Practice location:
  • Phone: 586-943-3653
  • Fax:
Mailing address:
  • Phone: 586-943-3653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: ANGEL CARTER
Title or Position: OWNER
Credential:
Phone: 586-943-3653