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General NPI Number Information
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NPI Number | 1891445789
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Entity Type | Organization
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Legal Business Name | 1ST ANGEL HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 8344 HALL RD STE 210A
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City | UTICA
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State | MI
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Zip | 48317-5554
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Country | US
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Telephone | 248-464-4920
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Fax |
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Provider Business Mailing Address
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Address Line | 8644 GOLF LANE DR
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City | COMMERCE TOWNSHIP
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State | MI
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Zip | 48382-3493
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Country | US
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Telephone | 602-545-8927
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Fax |
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Authorized Official
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Title or Position | OWNER DIRECTOR
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Name | NASSHAT KALASHO
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Credential |
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Telephone | 602-545-8927
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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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