Provider Demographics
NPI:1083854335
Name:GUARDIAN ANGELS PERSONAL CARE LLC
Entity Type:Organization
Organization Name:GUARDIAN ANGELS PERSONAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:N
Authorized Official - Last Name:LADNIER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-466-3500
Mailing Address - Street 1:2 N CHAMISA DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-9421
Mailing Address - Country:US
Mailing Address - Phone:505-466-3500
Mailing Address - Fax:505-995-8777
Practice Address - Street 1:2 N CHAMISA DR
Practice Address - Street 2:SUITE G
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-9421
Practice Address - Country:US
Practice Address - Phone:505-466-3500
Practice Address - Fax:505-995-8777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1T3298A1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health