Organization
GUARDIAN ANGEL HOME CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HYACINTH EDWINA REECE-HEADLEY MSM (EXECUTIVE DIRECTOR)
(919) 231-8683
Entity
Organization
Contact information
Practice address
1913 RIVERKNOLL DR, RALEIGH, NC 27610-4587
(919) 231-4599
(919) 231-4599
Mailing address
2201 WOODWYCK WAY, RALEIGH, NC 27604-6128
(919) 231-0226
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-092-530
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804762
—
NC
Enumeration date
02/22/2007
Last updated
08/22/2020
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