Guardian Angel Adult Day Services LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

GUARDIAN ANGEL ADULT DAY SERVICES LLC

Practice address

1028 Russwin St
Clarksdale, MS 38614-4610

Phone

(662) 902-2921

NPI assigned

Nov 16, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tineka Bailey

Title

Owner

Phone

(662) 902-2921

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1023352846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1052",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386141052",
            "telephone_number": "662-902-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 RUSSWIN ST",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386144610",
            "telephone_number": "662-902-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ANGEL ADULT DAY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-16",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "TINEKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-902-2921"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yolanda Grady
• April Green, ATC
• Alecia Greer, CNA
• Frances Parker Griffin, MSW
• Regina Denise Groner, NURSE PRACTITIONER
• Meghann E Gulledge Yee, M.ED.
• Cody Renaldo Gullick, FNP-C
• Mohamad F Hadidi, M.D.
• Undra L Haggan, NURSE PRACTITIONER
• Haggard Drug Store Inc.

• Adult Day Care Clinic/Center in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Adult Day Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.