Provider Demographics
NPI:1841799715
Name:BEDSIDE ANGEL'S HOME CARE, LLC
Entity Type:Organization
Organization Name:BEDSIDE ANGEL'S HOME CARE, LLC
Other - Org Name:BEDSIDE ANGEL'S HOME CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-678-6957
Mailing Address - Street 1:455 E EISENHOWER PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-3324
Mailing Address - Country:US
Mailing Address - Phone:734-678-6957
Mailing Address - Fax:734-270-2146
Practice Address - Street 1:455 E EISENHOWER PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3324
Practice Address - Country:US
Practice Address - Phone:734-678-6957
Practice Address - Fax:734-270-2146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1699212282OtherNPI