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NPI 1619030251

NPI 1619030251 : WINGS OF ANGEL HOME HEALTH CARE, LLC : SOUTHFIELD, MI

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General NPI Number Information
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    NPI Number           |    1619030251
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    Entity Type          |    Organization 
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    Legal Business Name  |    WINGS OF ANGEL HOME HEALTH CARE, LLC 
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Dates
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    Enumeration Date     |    12/18/2006
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    Last Update Date     |    06/03/2010
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Provider Practice Location Address
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    Address Line         |    16250 NORTHLAND DR SUITE 241
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    City                 |    SOUTHFIELD
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    State                |    MI
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    Zip                  |    48075-5227
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    Country              |    US
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    Telephone            |    248-443-8050
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    Fax                  |    248-443-8051
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Provider Business Mailing Address
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    Address Line         |    16250 NORTHLAND DR SUITE 241
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    City                 |    SOUTHFIELD
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    State                |    MI
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    Zip                  |    48075-5227
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    Country              |    US
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    Telephone            |    248-443-8050
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    Fax                  |    248-443-8051
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    MS. ANGELA MICHELLE PARKER GREER 
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    Credential           |    
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    Telephone            |    248-443-8050
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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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