Guardian Angel Home Care Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GUARDIAN ANGEL HOME CARE INC.

Practice address

3055 Kettering Blvd., Suite 307
Moraine, OH 45439-1949

Phone

(937) 643-3472

Fax

(937) 643-3483

NPI assigned

Sep 18, 2008

Last updated

Oct 4, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Sam D Kassab

Title

President/Ceo

Phone

(248) 293-2400

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Guardian Angel Home Care of Moraine

  • Home Health Agency
  • Moraine, OH
  • NPI 1609412014

  Sold to, 2020-04-01

  CMS change of ownership

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1427207026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 NORTHFIELD DRIVE",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "430933819",
            "telephone_number": "248-293-2418",
            "fax_number": "248-293-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 KETTERING BLVD., SUITE 307",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391949",
            "telephone_number": "937-643-3472",
            "fax_number": "937-643-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ANGEL HOME CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "KASSAB",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "248-293-2400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306778",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "368308",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3063778",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Preshia Griffin
• Edith Elizabeth Groover
• Morgan Grote
• Nicole Grove, FNP-C
• Sara Grundy
• Guardian Angel Home Care of Moraine
• Leonardo Guirnalda, MD
• Hannah Gumbs
• Anne Haas
• Marcus Haase

• Home Health Agency in Moraine, OH
• Providers in Moraine, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.