Organization
GUARDIAN ANGELS PRIMARY HOME CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLANCA E PERALES (OWNER)
(830) 421-8653
Entity
Organization
Contact information
Practice address
2808 MEMORIAL JR HIGH DR, EAGLE PASS, TX 78852-3894
(830) 421-8653
(830) 773-0008
Mailing address
2808 MEMORIAL JR HIGH DR, PO BOX 702, EAGLE PASS, TX 78852-3894
(830) 421-8653
(830) 773-0008
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LIC NO. 014640
TEXAS DEPARTMENT OF AGING AND DISABILITY SERVICES
TX
Enumeration date
03/24/2008
Last updated
04/30/2012
Update your record
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