Organization Active NPI

Guardian Angels in Home Services, LLC

  • Case Manager/Care Coordinator
  • Caruthersville, MO
National Provider Identifier
1093374266
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
GUARDIAN ANGELS IN HOME SERVICES, LLC
Practice address
1227 Laurant Ave
Caruthersville, MO 63830-2145
Phone
(573) 333-0777
Fax
(573) 333-1002
NPI assigned
Jun 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Carrie Hardaway, LPN
Title
Ceo
Phone
(573) 333-0777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X Primary

Addresses

Primary practice location

1227 Laurant Ave
Caruthersville, MO 63830-2145

Mailing address

PO Box 4
Caruthersville, MO 63830-0004
Phone (573) 333-0777

Other identifiers 1

IdentifierTypeStateIssuer
M279312904MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Guardian Angels in Home Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1093374266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638300004",
            "telephone_number": "573-333-0777",
            "fax_number": "573-333-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 LAURANT AVE",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638302145",
            "telephone_number": "573-333-0777",
            "fax_number": "573-333-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ANGELS IN HOME SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "HARDAWAY",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-333-0777",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M279312904",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caruthersville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.