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General NPI Number Information
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NPI Number | 1144326711
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGEL HOSPICE CARE FOR CHILDREN
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 08/10/2007
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Provider Practice Location Address
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Address Line | 514 W FULTON ST
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City | CANTON
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State | MS
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Zip | 39046-4254
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Country | US
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Telephone | 601-720-1187
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Fax | 601-859-1881
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Provider Business Mailing Address
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Address Line | 514 W FULTON ST
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City | CANTON
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State | MS
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Zip | 39046-4254
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Country | US
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Telephone | 601-720-1187
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Fax | 601-859-1881
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Authorized Official
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Title or Position | CEO
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Name | MS. LINDA GAIL DUNIGAN
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Credential | RN/MHA
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Telephone | 601-720-1187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 117
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License Number State | MS
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