Provider Demographics
NPI:1285457101
Name:ABLE ANGELS
Entity type:Organization
Organization Name:ABLE ANGELS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FALISA
Authorized Official - Middle Name:LATRESE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-333-9711
Mailing Address - Street 1:10157 ROLAN MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48111-8104
Mailing Address - Country:US
Mailing Address - Phone:313-333-9711
Mailing Address - Fax:
Practice Address - Street 1:10157 ROLAN MEADOWS DR
Practice Address - Street 2:
Practice Address - City:VAN BUREN TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48111-8104
Practice Address - Country:US
Practice Address - Phone:313-333-9711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty