# AUGUSTINE ANGELS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134990047
- **Authorized official:** MRS. TANISHA WILSON (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (267) 357-9124

## Contact information

- **Practice address:** 3200 GREENFIELD RD STE 300, DEARBORN, MI 48120-1805
- **Practice address phone:** (267) 357-9124
- **Mailing address:** 415 NATTULL DR, BEAR, DE 19701-4911
- **Mailing address phone:** (267) 357-9124

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/10/2024
- **Last updated:** 03/05/2024