Provider Demographics
NPI:1336782119
Name:GUARDIAN ANGELS HOSPICE CARE
Entity Type:Organization
Organization Name:GUARDIAN ANGELS HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BOROFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-417-5514
Mailing Address - Street 1:11621 STELLHORN RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:IN
Mailing Address - Zip Code:46774-9775
Mailing Address - Country:US
Mailing Address - Phone:260-417-5514
Mailing Address - Fax:
Practice Address - Street 1:11621 STELLHORN RD
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:IN
Practice Address - Zip Code:46774-9775
Practice Address - Country:US
Practice Address - Phone:260-417-5514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based