Organization
GUARDIAN ANGELS INDEPENDENT LIVING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY BOB ROSS SR. (OWNER)
(225) 922-4466
Entity
Organization
Contact information
Practice address
1821 WOODDALE CT, SUITE 104, BATON ROUGE, LA 70806-1535
(225) 922-4466
(225) 922-4420
Mailing address
1821 WOODDALE CT, SUITE 104, BATON ROUGE, LA 70806-1535
(225) 922-4466
(225) 922-4420
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
14010
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019950
—
LA
Enumeration date
11/27/2007
Last updated
11/27/2007
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