Provider Demographics
NPI:1659967727
Name:GUARDIAN ANGEL SERVICES, LLC.
Entity Type:Organization
Organization Name:GUARDIAN ANGEL SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-320-1314
Mailing Address - Street 1:7744 ISABEL AVE
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-1322
Mailing Address - Country:US
Mailing Address - Phone:141-932-0131
Mailing Address - Fax:
Practice Address - Street 1:271 CENTER RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2251
Practice Address - Country:US
Practice Address - Phone:419-320-1314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services