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General NPI Number Information
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NPI Number | 1982442141
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Entity Type | Organization
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Legal Business Name | ANGELA&ANGELAS HOUSE
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Dates
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Enumeration Date | 07/19/2024
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Last Update Date | 07/19/2024
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Provider Practice Location Address
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Address Line | 29554 BIRCHWOOD ST
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City | INKSTER
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State | MI
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Zip | 48141-1024
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Country | US
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Telephone | 313-826-9773
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Fax |
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Provider Business Mailing Address
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Address Line | 22430 GRATIOT AVE UNIT 667
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City | EASTPOINTE
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State | MI
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Zip | 48021-7030
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Country | US
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Telephone | 313-826-9773
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | ANGELA SHEPHERD
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Credential | NURSE
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Telephone | 313-826-9773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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