Provider Demographics
NPI:1215701180
Name:GUARDIAN ANGLES HOME ASSISTANCE LLC
Entity type:Organization
Organization Name:GUARDIAN ANGLES HOME ASSISTANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WAAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ORAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-622-1122
Mailing Address - Street 1:3234 LAKE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1883
Mailing Address - Country:US
Mailing Address - Phone:248-622-1122
Mailing Address - Fax:
Practice Address - Street 1:3234 LAKE FOREST DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-1883
Practice Address - Country:US
Practice Address - Phone:248-622-1122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty