Organization
ANGEL'S NEST, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BEVERLY LYNN WILKERSON MSW, LMSW, CAAC (SOCIAL WORKER)
(313) 529-1687
Entity
Organization
Contact information
Practice address
17340 W 12 MILE RD, SUITE 202, SOUTHFIELD, MI 48076-2122
(313) 529-1687
(888) 391-7092
Mailing address
17340 W 12 MILE RD, SUITE 202, SOUTHFIELD, MI 48076-2122
(313) 529-1687
(888) 391-7092
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
6801046795
MI
Other
Enumeration date
01/03/2011
Last updated
12/29/2012
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