NPIMap

Organization Active NPI

Guardian Angels Independent Living Services

  • Respite Care
  • Baton Rouge, LA
National Provider Identifier
1053593574
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
License
14010 Issued in LA
Legal business name
GUARDIAN ANGELS INDEPENDENT LIVING SERVICES
Practice address
1821 Wooddale CT
Suite 104
Baton Rouge, LA 70806-1535
Phone
(225) 922-4466
Fax
(225) 922-4420
NPI assigned
Nov 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Authorized official

Name
Johnny Bob Ross Sr.
Title
Owner
Phone
(225) 922-4466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X 14010 LA Primary

Addresses

Primary practice location

1821 Wooddale CT
Suite 104
Baton Rouge, LA 70806-1535

Mailing address

1821 Wooddale CT
Suite 104
Baton Rouge, LA 70806-1535
Phone (225) 922-4466

Other identifiers 1

IdentifierTypeStateIssuer
1019950MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Guardian Angels Independent Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1821 Wooddale Ct
Ste 104
Baton Rouge, LA 70806
Phone (225) 922-4466

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1053593574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 WOODDALE CT",
            "address_2": "SUITE 104",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708061535",
            "telephone_number": "225-922-4466",
            "fax_number": "225-922-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 WOODDALE CT",
            "address_2": "SUITE 104",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708061535",
            "telephone_number": "225-922-4466",
            "fax_number": "225-922-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ANGELS INDEPENDENT LIVING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "BOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-922-4466",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "LA",
            "license": "14010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019950",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.