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Organization

GUARDIAN ANGEL HOME CARE AGENCY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARIAN M. FUNDERBURK (PRESIDENT & CEO (DIRECTOR))
(704) 948-5654
Entity
Organization

Contact information

Practice address
7210 N LAKESIDE DR, CHARLOTTE, NC 28215-4012
(704) 948-5654
(704) 563-1341
Mailing address
7210 N LAKESIDE DR, CHARLOTTE, NC 28215-4012
(704) 948-5654
(704) 563-1341

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
251E00000X
Home Health Agency
251J00000X
Nursing Care Agency
Primary
253Z00000X
In Home Supportive Care Agency

Other

Enumeration date
09/09/2008
Last updated
03/28/2017
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