Organization
GUARDIAN ANGEL FAMILY CARE HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VANESSA G. PACKINGHAM (ADMINISTRATOR)
(336) 222-0114
Entity
Organization
Contact information
Practice address
1006 RICHMOND AVE, BURLINGTON, NC 27217-1525
(336) 222-0114
(336) 222-0114
Mailing address
1006 RICHMOND AVE, BURLINGTON, NC 27217-1525
(336) 222-0114
(336) 222-0114
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
FCL-001-118
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805761
—
NC
Enumeration date
02/19/2007
Last updated
11/27/2012
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