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General NPI Number Information
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NPI Number | 1780907881
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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 | 03/04/2010
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 2910 E INLAND SUITE 100
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City | ONTARIO
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State | CA
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Zip | 91764-4896
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Country | US
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Telephone | 909-983-0120
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Fax | 909-983-0163
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Provider Business Mailing Address
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Address Line | 1715 NORTHFIELD DRIVE
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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/PRESIDENT
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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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