Organization
GUARDIAN ANGELS IN HOME SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARRIE HARRIS (CEO)
(573) 204-3800
Entity
Organization
Contact information
Practice address
1335 OLD CAPE RD, SUITE F, JACKSON, MO 63755-2268
(573) 204-3800
(573) 204-3888
Mailing address
1335 OLD CAPE RD, SUITE F, JACKSON, MO 63755-2268
(573) 204-3800
(573) 204-3888
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
PENDING MISSOURI MEDICAID AS PAYOR
MO
Enumeration date
01/17/2012
Last updated
08/30/2012
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