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General NPI Number Information
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NPI Number | 1174610448
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGELS ELIM HOME CARE, INC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 403 MAIN ST NW
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City | ELK RIVER
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State | MN
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Zip | 55330-1533
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Country | US
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Telephone | 763-241-0654
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Fax | 763-241-0274
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Provider Business Mailing Address
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Address Line | 403 MAIN ST NW
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City | ELK RIVER
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State | MN
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Zip | 55330-1533
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Country | US
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Telephone | 763-241-0654
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Fax | 763-241-0274
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Authorized Official
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Title or Position | CEO
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Name | MS. ANDREA JUNG
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Credential |
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Telephone | 763-241-0654
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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 | 332158
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License Number State | MN
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