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General NPI Number Information
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NPI Number | 1467888669
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Entity Type | Organization
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Legal Business Name | PERFECT ANGELS LLC
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 26847 GRAND RIVER AVE SUITE 1
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City | REDFORD
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State | MI
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Zip | 48240-1544
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Country | US
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Telephone | 313-729-9758
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Fax |
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Provider Business Mailing Address
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Address Line | 26847 GRAND RIVER AVE SUITE 1
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City | REDFORD
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State | MI
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Zip | 48240-1544
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAMIKA MOBLEY
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Credential |
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Telephone | 313-729-9758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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