Provider Demographics
NPI:1073182150
Name:YOUR GUARDIAN ANGELS TRANSPORTATION LLC
Entity type:Organization
Organization Name:YOUR GUARDIAN ANGELS TRANSPORTATION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-689-8706
Mailing Address - Street 1:95 HANNA PKWY STE D
Mailing Address - Street 2:
Mailing Address - City:COVENTRY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44319-2165
Mailing Address - Country:US
Mailing Address - Phone:234-571-0975
Mailing Address - Fax:
Practice Address - Street 1:95 HANNA PKWY STE D
Practice Address - Street 2:
Practice Address - City:COVENTRY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44319-2165
Practice Address - Country:US
Practice Address - Phone:234-571-0975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No347B00000XTransportation ServicesBus
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No385HR2050XRespite Care FacilityRespite CareRespite Care CampGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0445504Medicaid