Organization
GUARDIAN ANGEL HOME HEALTH AGENCY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLEG PONOMARENKO (CFO)
(805) 581-0244
Entity
Organization
Contact information
Practice address
980 ENCHANTED WAY STE 206, SIMI VALLEY, CA 93065-0913
(805) 581-0244
(805) 581-0286
Mailing address
980 ENCHANTED WAY STE 206, SIMI VALLEY, CA 93065-0913
(805) 581-0244
(805) 581-0286
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
050000588
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA08299F
—
CA
Enumeration date
03/23/2006
Last updated
11/07/2022
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