Healthcare Provider Details

I. General information

NPI: 1255670923
Provider Name (Legal Business Name): GUARDIAN ANGELS NURSING CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2013
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5422 MULBERRY ST
PHILADELPHIA PA
19124-1252
US

IV. Provider business mailing address

5422 MULBERRY ST
PHILADELPHIA PA
19124-1252
US

V. Phone/Fax

Practice location:
  • Phone: 215-470-7533
  • Fax:
Mailing address:
  • Phone: 215-470-7533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberRN645239
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberRN645239
License Number StatePA

VIII. Authorized Official

Name: MS. TANGELA ROSE TURNER
Title or Position: OWNER
Credential:
Phone: 215-470-7533