Provider Demographics
NPI:1821359878
Name:GUARDIAN ANGELS PERSONAL CARE, LLC
Entity Type:Organization
Organization Name:GUARDIAN ANGELS PERSONAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RACQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RICCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-466-3500
Mailing Address - Street 1:9301 INDIAN SCHOOL RD NE
Mailing Address - Street 2:SUITE 208-E
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-2884
Mailing Address - Country:US
Mailing Address - Phone:505-466-3500
Mailing Address - Fax:
Practice Address - Street 1:9301 INDIAN SCHOOL RD NE
Practice Address - Street 2:SUITE 208-E
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2884
Practice Address - Country:US
Practice Address - Phone:505-466-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3391251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health