Provider Demographics
NPI:1881465102
Name:ANGEL TIME INC.
Entity type:Organization
Organization Name:ANGEL TIME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHEYLSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOETTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:151-739-5512
Mailing Address - Street 1:2175 JOLLY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3993
Mailing Address - Country:US
Mailing Address - Phone:517-709-2240
Mailing Address - Fax:
Practice Address - Street 1:2175 JOLLY RD STE 2
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3993
Practice Address - Country:US
Practice Address - Phone:517-709-2240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care