Organization
GUARDIAN ANGEL HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAULETTE H BUTLER PHD (CEO)
(601) 732-8473
Entity
Organization
Contact information
Practice address
6434 DALE DR, MARION, MS 39342-8704
(601) 482-5606
(601) 482-7801
Mailing address
41 S HALL RD, MORTON, MS 39117-8057
(601) 732-8473
(601) 732-8037
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1196
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00230168
—
MS
Enumeration date
02/21/2007
Last updated
08/22/2020
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