Provider Demographics
NPI:1508037425
Name:GUARDIAN ANGELS CARE SERVICES
Entity Type:Organization
Organization Name:GUARDIAN ANGELS CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-323-1059
Mailing Address - Street 1:810 N 29TH ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3704
Mailing Address - Country:US
Mailing Address - Phone:318-323-1059
Mailing Address - Fax:318-323-8511
Practice Address - Street 1:810 N 29TH ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3704
Practice Address - Country:US
Practice Address - Phone:318-323-1059
Practice Address - Fax:318-323-8511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization