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General NPI Number Information
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NPI Number | 1063328607
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Entity Type | Organization
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Legal Business Name | ANGELIC CARE GROUP HOME- SPECIALIZED AFC
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Dates
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Enumeration Date | 08/22/2026
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Last Update Date | 08/22/2026
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Provider Practice Location Address
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Address Line | 24548 SARGENT AVE
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3932
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Country | US
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Telephone | 248-403-0689
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Fax |
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Provider Business Mailing Address
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Address Line | 24548 SARGENT AVE
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3932
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Country | US
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Telephone | 248-403-0689
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Fax |
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Authorized Official
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Title or Position | ADMINITRATOR
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Name | TOCHUKWU ANYADIBE
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Credential |
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Telephone | 248-403-0689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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