Provider Demographics
NPI:1245686138
Name:GUARDIAN ANGELS, LLC
Entity type:Organization
Organization Name:GUARDIAN ANGELS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:DON
Authorized Official - Last Name:VICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-481-9775
Mailing Address - Street 1:106 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64105-1813
Mailing Address - Country:US
Mailing Address - Phone:816-237-8063
Mailing Address - Fax:816-421-1769
Practice Address - Street 1:106 W 11TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64105-1813
Practice Address - Country:US
Practice Address - Phone:816-237-8063
Practice Address - Fax:816-421-1769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health