Guardian Angel Home Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GUARDIAN ANGEL HOME CARE INC

Practice address

2905 Wilson Ave SW Suite 202
Grandville, MI 49418-1295

Phone

(616) 361-3940

Fax

(616) 361-3946

NPI assigned

Feb 1, 2007

Last updated

Mar 23, 2020By 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

Ceo

Phone

(248) 293-2400

Specialties & licenses 2

Addresses

Other identifiers 2

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 Grand Rapids

  • Home Health Agency
  • Grandville, MI
  • NPI 1659916633

  Sold to, 2020-04-01

  CMS change of ownership

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584921600000",
    "number": "1629116769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 NORTHFIELD DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093819",
            "telephone_number": "248-293-2400",
            "fax_number": "248-293-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 WILSON AVE SW SUITE 202",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181295",
            "telephone_number": "616-361-3940",
            "fax_number": "616-361-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ANGEL HOME CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A",
        "authorized_official_last_name": "KASSAB",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-293-2400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629116769",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5451846",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katlyn Rose Griessel, RBT
• Makenzie Griffin, CTRS
• Courtney Griffis
• Gro Optical, LLC (Grand Rapids Opticians, LLC)
• James Robert Grooters, MA, LLP
• Guardian Angel Home Care of Grand Rapids
• Cierra Lynn Guay I
• Gursharn S Dosanjh MD PC
• Jennifer Gushiken, PTA
• Mona Guyton, LLMSW

• Home Health Agency in Grandville, MI
• Providers in Grandville, MI by specialty
• Home Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; 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.