Provider Demographics
| NPI: | 1699569749 |
|---|---|
| Name: | HEART OF AN ANGEL LLC |
| Entity type: | Organization |
| Organization Name: | HEART OF AN ANGEL LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | MRS |
| Authorized Official - First Name: | ANGELA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | KEMPER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | PROVIDER |
| Authorized Official - Phone: | 586-252-0715 |
| Mailing Address - Street 1: | 29554 BIRCHWOOD ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | INKSTER |
| Mailing Address - State: | MI |
| Mailing Address - Zip Code: | 48141-1024 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 586-252-0715 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 29554 BIRCHWOOD ST |
| Practice Address - Street 2: | |
| Practice Address - City: | INKSTER |
| Practice Address - State: | MI |
| Practice Address - Zip Code: | 48141-1024 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 586-252-0715 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2025-04-05 |
| Last Update Date: | 2025-04-05 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 177F00000X | Other Service Providers | Lodging | |
| No | 174200000X | Other Service Providers | Meals | |
| No | 251G00000X | Agencies | Hospice Care, Community Based | |
| No | 253Z00000X | Agencies | In Home Supportive Care | |
| No | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness |
| No | 3104A0630X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Behavioral Disturbances |
| No | 311500000X | Nursing & Custodial Care Facilities | Alzheimer Center (Dementia Center) | |
| No | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home |
| No | 315P00000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Intellectual Disabilities | |
| No | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| No | 385H00000X | Respite Care Facility | Respite Care |
