Provider Demographics
NPI:1437781887
Name:GUARDIAN ANGEL CONCIERGE SERVICES LLC
Entity Type:Organization
Organization Name:GUARDIAN ANGEL CONCIERGE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:DONELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-753-7112
Mailing Address - Street 1:156 COLRAIN STAGE RD
Mailing Address - Street 2:
Mailing Address - City:COLRAIN
Mailing Address - State:MA
Mailing Address - Zip Code:01340-9506
Mailing Address - Country:US
Mailing Address - Phone:802-440-6958
Mailing Address - Fax:
Practice Address - Street 1:156 COLRAIN STAGE RD
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:MA
Practice Address - Zip Code:01346
Practice Address - Country:US
Practice Address - Phone:413-337-5377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No174200000XOther Service ProvidersMeals
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care