Provider Demographics
NPI:1508078981
Name:GUARDIAN ANGELS LLC
Entity Type:Organization
Organization Name:GUARDIAN ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-995-8333
Mailing Address - Street 1:1500 FIFTH STREET
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505
Mailing Address - Country:US
Mailing Address - Phone:505-995-8333
Mailing Address - Fax:505-995-8777
Practice Address - Street 1:1500 5TH ST
Practice Address - Street 2:SUITE 11
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3480
Practice Address - Country:US
Practice Address - Phone:505-995-8333
Practice Address - Fax:505-995-8777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0102661101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty