Provider Demographics
NPI:1285829705
Name:GUARDING ANGELS HOME CARE
Entity Type:Organization
Organization Name:GUARDING ANGELS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARAMEDIC
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:NREMTP
Authorized Official - Phone:800-881-2285
Mailing Address - Street 1:26230 LINWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4955
Mailing Address - Country:US
Mailing Address - Phone:800-881-2285
Mailing Address - Fax:
Practice Address - Street 1:26230 LINWOOD ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4955
Practice Address - Country:US
Practice Address - Phone:800-881-2285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704227590251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health