Guardian Angel Home Care, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

MHL-092-530 Issued in NC

Legal business name

GUARDIAN ANGEL HOME CARE, INC

Practice address

1913 Riverknoll Dr
Raleigh, NC 27610-4587

Phone

(919) 231-4599

Fax

(919) 231-4599

NPI assigned

Feb 22, 2007

Last updated

Aug 22, 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

Ms. Hyacinth Edwina Reece-Headley, MSM

Title

Executive Director

Phone

(919) 231-8683

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Guardian Angel Home Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Guardian Angel Home Care, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Raleigh, NC
  • NPI 1053451294
  NPD tax ID

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861527947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 WOODWYCK WAY",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276046128",
            "fax_number": "919-231-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 RIVERKNOLL DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276104587",
            "telephone_number": "919-231-4599",
            "fax_number": "919-231-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ANGEL HOME CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REECE-HEADLEY",
        "authorized_official_first_name": "HYACINTH",
        "authorized_official_middle_name": "EDWINA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-231-8683",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSM"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-092-530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804762",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Gryzik, AU.D.
• GSB Enterprise LLC
• Gerardo Guadarrama Jr., OD
• Lawrence Guan, MD
• Guardian Angel Home Care, Inc
• Guardian Care Solutions LLC
• Guardian Home Healthcare
• Guardian Medical Supplies, Inc.
• Michael Joseph Guardino, D.C.
• Lisa Clendennen Gubicza

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.