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General NPI Number Information
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NPI Number | 1285977249
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Entity Type | Organization
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Legal Business Name | ANGELS OF LOVE LLC
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 21931 GARDNER ST
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City | OAK PARK
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State | MI
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Zip | 48237-2683
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Country | US
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Telephone | 248-796-8004
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Fax | 248-808-6052
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Provider Business Mailing Address
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Address Line | 21931 GARDNER ST
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City | OAK PARK
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State | MI
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Zip | 48237-2683
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Country | US
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Telephone | 248-796-8004
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Fax | 248-808-6052
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Authorized Official
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Title or Position | PRESIDENT ADMINISTRATOR
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Name | MS. SHAWNELL CLARK
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Credential |
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Telephone | 248-796-8004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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