Provider Demographics
NPI:1841764594
Name:GUARD AN ANGEL HOMECARE SERVICES
Entity Type:Organization
Organization Name:GUARD AN ANGEL HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LVN
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRACKENS
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE/LVN
Authorized Official - Phone:281-845-1144
Mailing Address - Street 1:4435 ALGERNON DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-6803
Mailing Address - Country:US
Mailing Address - Phone:281-845-1141
Mailing Address - Fax:
Practice Address - Street 1:4435 ALGERNON DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-6803
Practice Address - Country:US
Practice Address - Phone:281-845-1141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty