Senior Angels Inc

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

SENIOR ANGELS INC

Practice address

9368 Forrer St
Detroit, MI 48228-2116

Phone

(313) 989-6527

NPI assigned

Aug 14, 2014

Organization subpart

No

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

Authorized official

Name

Lakeya Tramaine Stockton

Title

Owner

Phone

(313) 989-6527

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407974400000",
    "number": "1962801175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9368 FORRER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482282116",
            "telephone_number": "313-989-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9368 FORRER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482282116",
            "telephone_number": "313-989-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR ANGELS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A",
        "authorized_official_last_name": "STOCKTON",
        "authorized_official_first_name": "LAKEYA",
        "authorized_official_middle_name": "TRAMAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-989-6527"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Detroit, MI
• Providers in Detroit, MI by specialty
• Preferred Provider Organization in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.