Provider Demographics
NPI:1952724288
Name:ANGEL'S TEAM, INC.
Entity Type:Organization
Organization Name:ANGEL'S TEAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARAK
Authorized Official - Middle Name:
Authorized Official - Last Name:ISHAQ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-557-7302
Mailing Address - Street 1:2838 E LONG LAKE RD
Mailing Address - Street 2:STE 246
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-7012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2838 E LONG LAKE RD
Practice Address - Street 2:STE 246
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-7012
Practice Address - Country:US
Practice Address - Phone:586-577-7302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23D2071115Medicare Oscar/Certification