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General NPI Number Information
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NPI Number | 1982241204
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGELS PROVIDER SERVICES, INC
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Dates
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Enumeration Date | 12/05/2019
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 10333 HARWIN DR STE 674
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City | HOUSTON
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State | TX
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Zip | 77036-1571
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Country | US
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Telephone | 713-993-6888
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Fax | 713-993-6862
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Provider Business Mailing Address
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Address Line | 10333 HARWIN DR STE 685
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City | HOUSTON
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State | TX
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Zip | 77036-1571
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Country | US
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Telephone | 713-993-6888
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Fax | 713-993-6862
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Authorized Official
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Title or Position | CEO
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Name | JACQUELINE MOUTON
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Credential |
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Telephone | 713-993-6888
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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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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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