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General NPI Number Information
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NPI Number | 1932449980
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGELS REFERRAL AGENCY
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 4074 W BROWARD BLVD
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City | PLANTATION
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State | FL
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Zip | 33317-3767
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Country | US
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Telephone | 954-588-0246
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Fax | 954-583-9973
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Provider Business Mailing Address
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Address Line | 4074 W BROWARD BLVD
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City | PLANTATION
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State | FL
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Zip | 33317-3767
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Country | US
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Telephone | 954-588-0246
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Fax | 954-583-9973
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Authorized Official
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Title or Position | ADMINISTRATOR/ DIRECTOR
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Name | MS. TAEKO CUNNINGHAM
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Credential |
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Telephone | 954-588-0246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 232693
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License Number State | FL
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