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General NPI Number Information
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NPI Number | 1295789022
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGEL HOME HEALTH CARE, INC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 12/01/2016
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Provider Practice Location Address
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Address Line | 11617 E SR 67
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City | BICKNELL
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State | IN
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Zip | 47512-0095
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Country | US
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Telephone | 812-735-2811
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Fax | 812-735-2332
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Provider Business Mailing Address
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Address Line | 11617 E SR 67 PO BOX 95
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City | BICKNELL
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State | IN
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Zip | 47512-0095
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Country | US
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Telephone | 812-735-2811
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Fax | 812-735-2332
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. SHELBY LYNN MARCHINO
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Credential |
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Telephone | 812-735-2811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 06009556
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License Number State | IN
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