NPIMap

Organization Active NPI

Guardian Angel Healthcare, LLC

  • Community/Behavioral Health Agency
  • Norlina, NC
National Provider Identifier
1295308484
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GUARDIAN ANGEL HEALTHCARE, LLC
Practice address
119 Bynum PL
Norlina, NC 27563-9139
Phone
(252) 204-1381
Fax
(252) 598-0051
NPI assigned
Jul 23, 2021
Organization subpart
Yes
Parent organization
GUARDIAN ANGEL HEALTHCARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Cornelius Williams, BA
Title
President/Ceo
Phone
(252) 572-4005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

119 Bynum PL
Norlina, NC 27563-9139

Mailing address

PO Box 2002
Henderson, NC 27536-2002
Phone (252) 572-4005

Other names 1

  • Alieah's Place Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Guardian Angel Healthcarellc13 organizations share this tax ID, including this one
Part of
Guardian Angel Healthcarellc

Other organizations with this tax ID 12

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": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1295308484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2002",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362002",
            "telephone_number": "252-572-4005",
            "fax_number": "252-598-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BYNUM PL",
            "city": "NORLINA",
            "state": "NC",
            "postal_code": "275639139",
            "telephone_number": "252-204-1381",
            "fax_number": "252-598-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ANGEL HEALTHCARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUARDIAN ANGEL HEALTHCARE, LLC",
        "enumeration_date": "2021-07-23",
        "last_updated": "2023-09-06",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CORNELIUS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "252-572-4005",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alieah's Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norlina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.