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General NPI Number Information
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NPI Number | 1366729303
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Entity Type | Organization
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Legal Business Name | ANGELS ON WHEELS
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 2804 ORCHARD LAKE RD SUTIE 204 B
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City | KEEGO HARBOR
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State | MI
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Zip | 48320-1449
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Country | US
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Telephone | 248-773-1640
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Fax |
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Provider Business Mailing Address
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Address Line | 2804 ORCHARD LK RD. SUTIE 204 B
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City | KEEGO HARBOR
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State | MI
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Zip | 48320
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Country | US
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Telephone | 248-773-1640
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS IEISHA L HUSSAIN
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Credential |
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Telephone | 248-773-1640
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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 | D63483
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License Number State | MI
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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 | D63483
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License Number State | MI
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Taxonomy #3
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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 | MI
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