Provider Demographics
NPI:1639196074
Name:ANGEL HOME CARE SERVICES
Entity Type:Organization
Organization Name:ANGEL HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:RADEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-433-3460
Mailing Address - Street 1:7309 ROSEDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-1828
Mailing Address - Country:US
Mailing Address - Phone:313-433-3460
Mailing Address - Fax:
Practice Address - Street 1:7309 ROSEDALE BLVD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-1828
Practice Address - Country:US
Practice Address - Phone:313-433-3460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health