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General NPI Number Information
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NPI Number | 1093027187
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGEL COMMUNITY SERVICES
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 1550 PLAINFIELD RD
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City | JOLIET
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State | IL
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Zip | 60435-3752
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Country | US
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Telephone | 815-729-0930
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Fax | 815-744-6087
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Provider Business Mailing Address
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Address Line | 1550 PLAINFIELD RD.
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City | JOLIET
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State | IL
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Zip | 60435
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Country | US
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Telephone | 815-729-0930
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Fax | 815-744-6087
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Authorized Official
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Title or Position | CEO
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Name | DR. SHEILA A SCHMITZ
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Credential |
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Telephone | 815-729-0930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | 032673
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License Number State | IL
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