Provider Demographics
NPI:1669191508
Name:GUARDIAN ANGELS HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:GUARDIAN ANGELS HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWNNETTA
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:253-259-9794
Mailing Address - Street 1:17719 N BEACHSIDE DR SE
Mailing Address - Street 2:
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597-9375
Mailing Address - Country:US
Mailing Address - Phone:360-910-9164
Mailing Address - Fax:360-443-7570
Practice Address - Street 1:17719 N BEACHSIDE DR SE
Practice Address - Street 2:
Practice Address - City:YELM
Practice Address - State:WA
Practice Address - Zip Code:98597-9375
Practice Address - Country:US
Practice Address - Phone:360-910-9164
Practice Address - Fax:360-443-7570
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUARDIAN ANGELS HOME HEALTH SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service