Organization
GUARDIAN ANGEL HOME CARE OF LAS VEGAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM D KASSAB (PRESIDENT/CEO)
(248) 293-2400
Entity
Organization
Contact information
Practice address
150 N. DURANGO DRIVE, SUITE 150, LAS VEGAS, NV 89145-5604
(702) 450-1855
(702) 450-1854
Mailing address
1715 NORTHFIELD DR., ROCHESTER HILLS, MI 48309-3819
(248) 293-2418
(248) 293-2401
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700416179
—
NV
05
—
170962669
—
NV
Enumeration date
01/24/2020
Last updated
11/29/2024
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