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General NPI Number Information
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NPI Number | 1497917041
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGEL HOME CARE, INC.
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 10000 N. 31ST AVENUE SUITE B111
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City | PHOENIX
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State | AZ
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Zip | 85051-0907
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Country | US
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Telephone | 330-752-0141
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Fax | 248-293-2401
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Provider Business Mailing Address
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Address Line | 1715 NORTHFIELD DRIVE GUARDIAN ANGEL HOME CARE, INC.
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-3819
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Country | US
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Telephone | 248-293-2400
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Fax | 248-293-2401
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Authorized Official
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Title or Position | CEO
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Name | MR. SAM D. KASSAB
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Credential |
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Telephone | 248-293-2400
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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