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General NPI Number Information
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NPI Number | 1801229018
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGEL HOME HEALTH
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 211 N UNION ST #100 OLD TOWN
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2657
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Country | US
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Telephone | 703-519-1255
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Fax |
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Provider Business Mailing Address
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Address Line | 211 N UNION ST #100 OLD TOWN
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2657
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Country | US
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Telephone | 703-519-1255
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Fax |
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Authorized Official
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Title or Position | NURSING DIRECTOR
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Name | MRS. CHIYERE OTUYA
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Credential | REGISTERED NURSE
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Telephone | 240-462-9940
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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 | 4626066468
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License Number State | VA
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