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General NPI Number Information
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NPI Number | 1538569942
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGEL HOME HEALTH INC
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Dates
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Enumeration Date | 09/04/2014
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 5680 KING CENTRE DR STE 600
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City | ALEXANDRIA
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State | VA
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Zip | 22315-5755
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Country | US
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Telephone | 703-519-1255
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Fax | 703-454-0722
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Provider Business Mailing Address
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Address Line | 5680 KING CENTRE DR STE 600
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City | ALEXANDRIA
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State | VA
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Zip | 22315-5755
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Country | US
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Telephone | 703-519-1255
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Fax | 703-454-0722
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Authorized Official
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Title or Position | OWNER
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Name | CHINYERE LOIS OTUYA
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Credential |
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Telephone | 703-504-8322
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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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO151190
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License Number State | VA
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