Guardian Angels Health Services, Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

GUARDIAN ANGELS HEALTH SERVICES, INC.

Practice address

9200 Quantrelle Ave NE
Otsego, MN 55330-1048

Phone

(763) 746-3400

Fax

(763) 635-5480

NPI assigned

Sep 24, 2019

Organization subpart

Yes

Parent organization

GUARDIAN ANGELS HEALTH SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Daniel James Fair, DO

Title

Administrator

Phone

(763) 241-4428

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Angels On Main Doing business as

Tax ID family

Guardian Angels Health Services Inc2 organizations share this tax ID, including this one

Part of

Guardian Angels Health Services Inc

Other organizations with this tax ID 1

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

• Guardian Angels Health Services, Inc.

  • Skilled Nursing Facility
  • Elk River, MN
  • NPI 1861499204
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Guardian Angels Health Services, Inc.

  • Skilled Nursing Facility
  • Elk River, MN
  • NPI 1861499204
  NPPES parent name

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569283200000",
    "number": "1730730508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 FREEPORT AVE NW STE A",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301874",
            "telephone_number": "763-635-4483",
            "fax_number": "763-241-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 QUANTRELLE AVE NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553301048",
            "telephone_number": "763-746-3400",
            "fax_number": "763-635-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ANGELS HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUARDIAN ANGELS HEALTH SERVICES, INC.",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A",
        "authorized_official_last_name": "FAIR",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "763-241-4428",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN DEPARTMENT OF HUMAN SERVICES",
            "identifier": "M112023900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angels On Main",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Andrea Michelle Hendel, MA, LMFT

• All providers in Otsego, MN
• Adult Day Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.