Provider Demographics
NPI:1952868861
Name:LOVING ANGELS OF MICHIGAN
Entity type:Organization
Organization Name:LOVING ANGELS OF MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUANNA
Authorized Official - Middle Name:NONE
Authorized Official - Last Name:WOODHULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-914-5179
Mailing Address - Street 1:25711 W WARREN ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2046
Mailing Address - Country:US
Mailing Address - Phone:313-914-5179
Mailing Address - Fax:866-295-8032
Practice Address - Street 1:25711 W WARREN ST
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2046
Practice Address - Country:US
Practice Address - Phone:313-914-5179
Practice Address - Fax:866-295-8032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No174200000XOther Service ProvidersMeals
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care