Provider Demographics
NPI:1215824297
Name:ST. RICHARD'S ANGELS HOME HELP LLC
Entity type:Organization
Organization Name:ST. RICHARD'S ANGELS HOME HELP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JALISA
Authorized Official - Middle Name:SHAWNEA
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:734-239-3310
Mailing Address - Street 1:4233 MARYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3652
Mailing Address - Country:US
Mailing Address - Phone:734-239-3310
Mailing Address - Fax:
Practice Address - Street 1:4233 MARYWOOD DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-3652
Practice Address - Country:US
Practice Address - Phone:734-239-3310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty