Provider Demographics
NPI:1154914802
Name:GUARDIAN ANGEL HOME HEALTH LLC
Entity type:Organization
Organization Name:GUARDIAN ANGEL HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:DYANA
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-592-8499
Mailing Address - Street 1:2618 CHRISTINE BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-1643
Mailing Address - Country:US
Mailing Address - Phone:614-592-8499
Mailing Address - Fax:
Practice Address - Street 1:2700 E DUBLIN GRANVILLE RD STE 427
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-4094
Practice Address - Country:US
Practice Address - Phone:614-505-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health