Provider Demographics
NPI:1447598081
Name:ANGEL HOSPICE, INC.
Entity Type:Organization
Organization Name:ANGEL HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLINGSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-593-5553
Mailing Address - Street 1:30700 TELEGRAPH RD
Mailing Address - Street 2:SUITE 2540
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4524
Mailing Address - Country:US
Mailing Address - Phone:248-593-5553
Mailing Address - Fax:248-593-9120
Practice Address - Street 1:30700 TELEGRAPH RD
Practice Address - Street 2:SUITE 2540
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4524
Practice Address - Country:US
Practice Address - Phone:248-593-5553
Practice Address - Fax:248-593-9120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
231636Medicare Oscar/Certification