Organization
ANGELS ON GUARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEENANNE EVANS RN, BS EDU, LMT (ADMINISTRATOR)
(585) 468-5570
Entity
Organization
Contact information
Practice address
9552 ROUTE 408 SOUTH RD, NUNDA, NY 14517
(585) 468-5570
Mailing address
PO BOX 576, NUNDA, NY 14517-0576
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
271796
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659680866
—
NY
Enumeration date
01/03/2011
Last updated
01/03/2011
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