Provider Demographics
NPI:1891296422
Name:GUARDIAN ANGEL'S ADULT DAY HEALT CARE, LLC
Entity Type:Organization
Organization Name:GUARDIAN ANGEL'S ADULT DAY HEALT CARE, LLC
Other - Org Name:GUARDIAN ANGLE'S ADULT DAY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TENG
Authorized Official - Middle Name:
Authorized Official - Last Name:VANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-492-1621
Mailing Address - Street 1:4837 E. MCKINLEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703
Mailing Address - Country:US
Mailing Address - Phone:559-492-1621
Mailing Address - Fax:559-492-2759
Practice Address - Street 1:4837 E. MCKINLEY AVENUE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703
Practice Address - Country:US
Practice Address - Phone:559-492-1621
Practice Address - Fax:559-492-2759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care