# GUARDIAN ANGEL HOMES LLC

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

## Provider details

- **NPI number:** 1710648100
- **Authorized official:** TASHA WILLIS (OWNER)
- **Authorized official phone:** (262) 883-7817

## Contact information

- **Practice address:** 815 8TH ST APT M08, RACINE, WI 53403-1491
- **Practice address phone:** (262) 883-7817
- **Mailing address:** 815 8TH ST APT M08, RACINE, WI 53403-1491
- **Mailing address phone:** (262) 883-7817

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/07/2022
- **Last updated:** 01/07/2022