GUARDIAN ANGEL HOMES LLC (NPI# 1285134965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285134965 |
| Entity Type | Organization |
| Organization Name | GUARDIAN ANGEL HOMES LLC |
| Practice Address |
1038 Woodbridge St Jackson MI 49203-3112 |
| Mailing Address |
725 N Dettman Rd Jackson MI 49202-2605 |
| Practice Telephone | 5179141039 |
| Mailing Telephone | 5179141039 |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2018-02-19 |
| Authorized Official Name | REYNALDO S PATINO (ADMINISTRATIVE MANAGER) |
| Authorized Official Telephone | 5179141039 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | AS380389381 | MI | Residential Treatment Facilities |
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | AS380389381 | MI | Residential Treatment Facilities |
| Street Address |
1038 WOODBRIDGE ST |
| City | JACKSON |
| State | MI |
| Zip Code | 49203-3112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760900120 | Cynthia A Rider Dmd Pllc | Oral & Maxillofacial Surgery | 2545 Spring Arbor Road, Suite 202, Jackson, MI 49203 | 2017-09-06 |
| 1407224280 | Lucinda Gail Taggart | Licensed Practical Nurse | 1515 Greenwood Ave., Jackson, MI 49203 | 2015-09-10 |
| 1134514045 | Christopher Dauterman | Registered Nurse | 1320 East Mcdevitt, Jackson, MI 49203 | 2015-03-30 |
| 1710386826 | Steven Andrew Edwards | Social Worker | 505 Hickory Court, #2d, Jackson, MI 49203 | 2014-08-14 |
| 1861800666 | Michigan Continuum Care Pllc | Internal Medicine | 1310 Greenwood Ave., Jackson, MI 49203 | 2014-07-25 |
| 1497014831 | Barbara Cliffe-miller | Physical Therapist | 3510 Page Ave, Jackson, MI 49203 | 2012-05-04 |
| 1871822718 | Sharon Ann Arendsen | Respite Care | 4043 Clarkway Rd, Jackson, MI 49203 | 2009-12-23 |
| 1669700456 | Teresa Lynn Cox | Technician, Other | 3884 Franklin Rd., Jackson, MI 49203 | 2009-12-07 |
| 1942537097 | Stacy Marie Chinevere I | Counselor | 326 Johnson St, Jackson, MI 49203 | 2009-11-11 |
| 1366672370 | Sarah Elizabeth Hazlett | Counselor | 1522joy Avenue, Jackson, MI 49203 | 2009-07-24 |
| Find all providers in zip 49203 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780208116 | Indya Daniels | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 262 Carriage House Dr, Jackson, TN 38305-2228 | 2020-06-01 |
| 1871088922 | Tate Enterprises, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1105 Laura Ave, Jackson, MS 39209-7008 | 2018-06-29 |
| 1609375781 | Advancing Opportunities, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 976 W Veterans Hwy, Jackson, NJ 08527-3337 | 2018-02-05 |
| 1841670775 | The Open Door of Nj | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 319 Sapphire Dr, Jackson, NJ 08527-1364 | 2015-06-05 |
| 1699155887 | Developmental Disabilities Association of Nj Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 609 Henry St, Jackson, NJ 08527-4650 | 2015-06-03 |
| 1982084075 | National Mentor Healthcare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 880 Wright Debow Rd, Jackson, NJ 08527-5428 | 2015-06-03 |
| 1760861389 | The Arc Ocean County Chapter, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 76 Buckingham Dr, Jackson, NJ 08527-2640 | 2015-05-28 |
| 1588074116 | Morning Star Behavioral Associates LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 219 Quail Crk, Jackson, MO 63755-3810 | 2014-05-05 |
| 1174868707 | Household of Faith | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 341 Old Griffin Rd, Jackson, GA 30233-4952 | 2012-12-07 |
| 1053682724 | Center for Family Life Extension, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1160 Mclean St, Jackson, MS 39209-7251 | 2012-01-26 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.