Angel's Nest, Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

6801046795 Issued in MI

Legal business name

ANGEL'S NEST, INC.

Practice address

17340 W 12 Mile Rd
Suite 202
Southfield, MI 48076-2122

Phone

(313) 529-1687

Fax

(888) 391-7092

NPI assigned

Jan 3, 2011

Last updated

Dec 29, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Beverly Lynn Wilkerson, MSW, LMSW, CAAC

Title

Social Worker

Phone

(313) 529-1687

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356739200000",
    "number": "1215231493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17340 W 12 MILE RD",
            "address_2": "SUITE 202",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762122",
            "telephone_number": "313-529-1687",
            "fax_number": "888-391-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17340 W 12 MILE RD",
            "address_2": "SUITE 202",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762122",
            "telephone_number": "313-529-1687",
            "fax_number": "888-391-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL'S NEST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-03",
        "last_updated": "2012-12-29",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "313-529-1687",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, LMSW, CAAC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MI",
            "license": "6801046795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.