Provider Demographics
NPI:1417460155
Name:GUARDIAN ANGELS HOME CARE
Entity Type:Organization
Organization Name:GUARDIAN ANGELS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEADBEATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-569-1068
Mailing Address - Street 1:385 SMITHFIELD HIGHHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:15478-1237
Mailing Address - Country:US
Mailing Address - Phone:724-569-1068
Mailing Address - Fax:724-569-8655
Practice Address - Street 1:385 SMITHFIELD HIGHHOUSE RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:PA
Practice Address - Zip Code:15478-1237
Practice Address - Country:US
Practice Address - Phone:724-569-1068
Practice Address - Fax:724-569-8655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11313601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health