Healthcare Provider Details

I. General information

NPI: 1376037234
Provider Name (Legal Business Name): GUARDIAN ANGELS HOMECARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 SOUTH 48TH STREET, SUITE 118
LINCOLN NE
68516-4110
US

IV. Provider business mailing address

5600 SOUTH 48TH STREET, SUITE 118
LINCOLN NE
68516-4110
US

V. Phone/Fax

Practice location:
  • Phone: 402-474-4000
  • Fax: 775-305-2470
Mailing address:
  • Phone: 402-474-4000
  • Fax: 775-305-2470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LISA LYNN MARKS
Title or Position: DIRECTOR
Credential:
Phone: 402-474-4000