Basic Information
Provider Information
NPI: 1447598081
EntityType: 2
ReplacementNPI:  
OrganizationName: ANGEL HOSPICE, INC.
LastName:  
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Mailing Information
Address1: 30700 TELEGRAPH RD
Address2: SUITE 2540
City: BINGHAM FARMS
State: MI
PostalCode: 480254524
CountryCode: US
TelephoneNumber: 2485935553
FaxNumber: 2485939120
Practice Location
Address1: 30700 TELEGRAPH RD
Address2: SUITE 2540
City: BINGHAM FARMS
State: MI
PostalCode: 480254524
CountryCode: US
TelephoneNumber: 2485935553
FaxNumber: 2485939120
Other Information
ProviderEnumerationDate: 01/16/2013
LastUpdateDate: 05/26/2015
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: BILLINGSLEY
AuthorizedOfficialFirstName: SIDNEY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: ADMINISTRATOR
AuthorizedOfficialTelephone: 2485935553
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251G00000X  Y AgenciesHospice Care, Community Based 

No ID Information.


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