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General NPI Number Information
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NPI Number | 1659967727
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGEL SERVICES, LLC.
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Dates
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Enumeration Date | 12/14/2020
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Last Update Date | 12/14/2020
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Provider Practice Location Address
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Address Line | 271 CENTER RD
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City | BEDFORD
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State | OH
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Zip | 44146-2251
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Country | US
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Telephone | 419-320-1314
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Fax |
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Provider Business Mailing Address
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Address Line | 7744 ISABEL AVE
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City | HUDSON
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State | OH
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Zip | 44236-1322
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Country | US
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Telephone | 141-932-0131
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SELENA NEWELL
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Credential |
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Telephone | 419-320-1314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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