| Organization Name: | ANGELIC HEART HOSPICE, INC. |
| NPI Number: | 1245629955 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MUKESH K. SURYAVANSHI (PRESIDENT) |
| Mailing Address: | 1040 S State Rd Davison |
| State: | MI US |
| Postal Code: | 484231904 |
| Phone Number: | 8104125177 |
| Fax Number: | 8104124376 |
| NPI Enumeration Date: | 01/19/2015 |
| NPI Last Update Date: | 10/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 1041000146 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |