Provider Demographics
NPI:1174852198
Name:ANGEL CARE HOMES, INC
Entity Type:Organization
Organization Name:ANGEL CARE HOMES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:C
Authorized Official - Last Name:UDANOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-387-6042
Mailing Address - Street 1:16565 SUNDERLAND RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-4002
Mailing Address - Country:US
Mailing Address - Phone:313-387-6042
Mailing Address - Fax:
Practice Address - Street 1:16565 SUNDERLAND RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-4002
Practice Address - Country:US
Practice Address - Phone:313-387-6042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health