Healthcare Provider Details

I. General information

NPI: 1598793291
Provider Name (Legal Business Name): GUARDIAN ANGEL HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 08/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2641 SOUTH ARLINGTON ROAD
AKRON OH
44319-2044
US

IV. Provider business mailing address

1715 NORTHFIELD DRIVE
ROCHESTER HILLS MI
48309-3819
US

V. Phone/Fax

Practice location:
  • Phone: 330-493-4707
  • Fax: 248-293-2401
Mailing address:
  • Phone: 248-293-2400
  • Fax: 248-293-2401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. SAM D. KASSAB
Title or Position: CEO
Credential: CEO PRESIDENT OWNER
Phone: 248-293-2400