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Organization

GUARDIAN ANGEL HEALTHCARE, LLC

Active
Other names
Esther's Place Facility
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CORNELIUS WILLIAMS (PRESIDENT/REGISTERED AGENT)
(252) 204-1381
Entity
Organization

Contact information

Practice address
270 CHARLES ST, HENDERSON, NC 27536-4328
(252) 572-4487
(252) 572-2147
Mailing address
270 CHARLES ST, HENDERSON, NC 27536-4328
(252) 572-4487
(252) 572-2147

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-091-087
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3418365
NC
Enumeration date
06/22/2010
Last updated
09/25/2021
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