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General NPI Number Information
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NPI Number | 1730730508
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGELS HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 09/24/2019
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 9200 QUANTRELLE AVE NE
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City | OTSEGO
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State | MN
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Zip | 55330-1048
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Country | US
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Telephone | 763-746-3400
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Fax | 763-635-5480
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Provider Business Mailing Address
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Address Line | 508 FREEPORT AVE NW STE A
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City | ELK RIVER
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State | MN
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Zip | 55330-1874
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Country | US
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Telephone | 763-635-4483
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Fax | 763-241-4443
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DANIEL JAMES FAIR
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Credential | DO
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Telephone | 763-241-4428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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