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Organization
MY GUARDIAN ANGEL FAMILY CARE HOME
Active
Organization
MY GUARDIAN ANGEL FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERNON BRYANT (OWNER)
(252) 813-1939
Entity
Organization
Contact information
Practice address
514 COKEY ROAD, ROCKY MOUNT, NC 27801
(252) 977-3368
(252) 977-3368
Mailing address
2001 VERNON ROAD, ROCKY MOUNT, NC 27801-6348
(252) 977-3368
(252) 977-3368
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
—
NULL
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
347C00000X
Private Vehicle
—
NULL
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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