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General NPI Number Information
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NPI Number | 1962652529
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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 | 09/19/2008
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Last Update Date | 10/27/2016
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Provider Practice Location Address
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Address Line | 4889 SINCLAIR ROAD SUITE 109
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City | COLUMBUS
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State | OH
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Zip | 43229-5432
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Country | US
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Telephone | 614-297-4757
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Fax | 614-781-1497
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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 | 248-293-2418
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Fax | 248-293-2401
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Authorized Official
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Title or Position | PRESIDENT/CEO
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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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