Provider Demographics
NPI:1316228133
Name:ANGELIC GUARDIAN HEALTH CARE, LLC
Entity Type:Organization
Organization Name:ANGELIC GUARDIAN HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONSU
Authorized Official - Suffix:
Authorized Official - Credentials:AIDE
Authorized Official - Phone:614-516-3746
Mailing Address - Street 1:3110 VISTA VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6924
Mailing Address - Country:US
Mailing Address - Phone:614-516-3746
Mailing Address - Fax:614-577-0966
Practice Address - Street 1:3110 VISTA VIEW BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6924
Practice Address - Country:US
Practice Address - Phone:614-516-3746
Practice Address - Fax:614-577-0966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health