Organization
GUARDIAN ANGELS INDEPENDENT LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHNNY BOB ROSS SR. (OWNER)
(225) 922-4466
Entity
Organization
Contact information
Practice address
1821 WOODALE COURT SUITE 104, BATON ROUGE, LA 70806-1535
(225) 922-4466
(225) 922-4420
Mailing address
1821 WOODALE COURT SUITE 104, BATON ROUGE, LA 70806
(225) 922-4466
(225) 922-4420
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
14010
LA
385H00000X
Respite Care
Primary
14010
LA
Other
Enumeration date
08/30/2007
Last updated
11/26/2007
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