# MY GUARDIAN ANGEL

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

## Provider details

- **NPI number:** 1356190094
- **Authorized official:** DIANE DOUCETTE (PROVIDER/OWNER)
- **Authorized official phone:** (248) 910-4467

## Contact information

- **Practice address:** 2460 GEORGELAND DR, WATERFORD, MI 48329-3744
- **Practice address phone:** (248) 673-5505
- **Mailing address:** 25680 CATALINA ST, SOUTHFIELD, MI 48075-1739
- **Mailing address phone:** (248) 910-4467

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/15/2024
- **Last updated:** 05/15/2024