# GUARDIAN ANGEL CARE MIHP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114560364
- **Authorized official:** TONJIA PETERSON (OWNER)
- **Authorized official phone:** (734) 858-7709

## Contact information

- **Practice address:** 4609 S WAYNE RD STE 1, WAYNE, MI 48184-2310
- **Practice address phone:** (734) 858-7709
- **Practice address fax:** (734) 858-7802
- **Mailing address:** 30169 JAMESTOWN ST, ROMULUS, MI 48174-3149
- **Mailing address phone:** (734) 858-7709
- **Mailing address fax:** (734) 858-7802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/21/2019
- **Last updated:** 02/01/2024