Provider Demographics
NPI:1265450993
Name:DEL NORTE HOME CARE LLC DBA GUARDIAN ANGEL HOME HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:DEL NORTE HOME CARE LLC DBA GUARDIAN ANGEL HOME HEALTHCARE SERVICES
Other - Org Name:GUARDIAN ANGEL HOME HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:C
Authorized Official - Last Name:IKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD/ BSN
Authorized Official - Phone:915-594-1116
Mailing Address - Street 1:1537 N ZARAGOZA RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-8095
Mailing Address - Country:US
Mailing Address - Phone:915-594-1116
Mailing Address - Fax:915-849-7825
Practice Address - Street 1:1537 N ZARAGOZA RD STE 2A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-8095
Practice Address - Country:US
Practice Address - Phone:915-594-1116
Practice Address - Fax:915-849-7825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002386251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX011677OtherTEXAS HEALTH AND HUMAN SERVICES COMMISSION
TX024682901Medicaid
TX677523Medicare PIN
TX677523Medicare Oscar/Certification