Provider Demographics
NPI:1972029353
Name:CHERUB ENTERPRISES
Entity Type:Organization
Organization Name:CHERUB ENTERPRISES
Other - Org Name:VISITING ANGELS OF SOUTHWEST MICHIGAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KLUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-459-6464
Mailing Address - Street 1:5413 S WESTNEDGE AVE STE D-E
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002-0453
Mailing Address - Country:US
Mailing Address - Phone:269-459-6464
Mailing Address - Fax:269-348-0079
Practice Address - Street 1:5413 S WESTNEDGE AVE STE D-E
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-0453
Practice Address - Country:US
Practice Address - Phone:269-459-6464
Practice Address - Fax:269-348-0079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care