Healthcare Provider Details

I. General information

NPI: 1720475809
Provider Name (Legal Business Name): GUARDIAN ANGEL HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 04/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 E COMMERCECENTER DR STE 240
BAKERSFIELD CA
93309-1688
US

IV. Provider business mailing address

1715 NORTHFIELD DR
ROCHESTER HILLS MI
48309-3819
US

V. Phone/Fax

Practice location:
  • Phone: 661-395-3035
  • Fax:
Mailing address:
  • Phone: 248-293-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SAM KASSAB
Title or Position: CEO/PRESIDENT
Credential:
Phone: 248-293-2400