Organization
CARE DIVINE OF GUARDIAN ANGEL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARGARET C IKE M.D (PRESIDENT/CEO)
(915) 307-4234
Entity
Organization
Contact information
Practice address
3135 TRAWOOD DR, EL PASO, TX 79936
(915) 307-4234
(915) 307-4027
Mailing address
1537 N. ZARAGOZA RD., SUITE 2-A, EL PASO, TX 79936
(915) 307-4234
(915) 307-4027
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147231864
—
TX
Enumeration date
10/23/2014
Last updated
02/24/2022
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