Organization Active NPI

Guardian Angel Healthcare, LLC

  • Community/Behavioral Health Agency
  • Henderson, NC
National Provider Identifier
1982434510
Registry record updated Aug 7, 2024
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
448 Summit Rd
Henderson, NC 27537-4529
Phone
(252) 430-3135
Fax
(252) 598-0051
NPI assigned
Aug 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

448 Summit Rd
Henderson, NC 27537-4529

Mailing address

PO Box 2002
Henderson, NC 27536-2002
Phone (252) 204-1381

Other names 1

  • Shelton's Place Facility Doing business as

National Provider Directory

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

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": "1722988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1982434510",
    "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": "252-204-1381",
            "fax_number": "252-598-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 SUMMIT RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275374529",
            "telephone_number": "252-430-3135",
            "fax_number": "252-598-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ANGEL HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "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"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelton's Place Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.