Provider Demographics
NPI:1811785751
Name:GUARDIAN ANGELS HOMECARE AGENCY LLC
Entity type:Organization
Organization Name:GUARDIAN ANGELS HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-670-6784
Mailing Address - Street 1:3 S BROAD ST STE 3B13
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-4627
Mailing Address - Country:US
Mailing Address - Phone:856-845-1914
Mailing Address - Fax:856-845-1879
Practice Address - Street 1:3 S BROAD ST STE 3B13
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-4627
Practice Address - Country:US
Practice Address - Phone:856-845-1914
Practice Address - Fax:856-845-1879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty