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Organization
MY3ANGELS LLC.
Active
Organization
MY3ANGELS LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUANITA HICKMON (PRESIDENT)
(248) 650-2104
Entity
Organization
Contact information
Practice address
54134 OVERBROOK CT., SHELBY TWSP, MI 48316
(248) 650-2104
Mailing address
54134 OVERBROOK CT., SHELBY TWSP, MI 48316
(248) 650-2104
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
302R00000X
Health Maintenance Organization
—
NULL
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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