MEDICARE: ANGELS OF OAKLAND, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	174200000X	Meals Provider
2	251E00000X	Home Health Agency
3	385H00000X	Respite Care
4	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1033676770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELS OF OAKLAND, INC.

Provider Business Mailing Address
First Line	:	3965 W AUBURN RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-3140
Country	:	US
Telephone Number	:	248-649-8890
Fax Number	:

Provider Business Practice Location Address
First Line	:	3965 W AUBURN RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-3140
Country	:	US
Telephone Number	:	248-649-8890
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHEN NOVAK
Credential	:
Telephone Number	:	586-726-6999

Provider Enumeration Date	:	03/01/2019
Last Update Date	:	03/01/2019

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