GUARDIAN ANGELS HEALTH SERVICES, INC. (NPI# 1730730508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730730508 |
| Entity Type | Organization |
| Organization Name | GUARDIAN ANGELS HEALTH SERVICES, INC. |
| Other Organization Name | ANGELS ON MAIN |
| Practice Address |
9200 Quantrelle Ave Ne Otsego MN 55330-1048 |
| Mailing Address |
508 Freeport Ave Nw Ste A Elk River MN 55330-1874 |
| Practice Telephone | 7637463400 |
| Practice Fax Number | 7636355480 |
| Mailing Telephone | 7636354483 |
| Mailing Fax Number | 7632414443 |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2019-09-24 |
| Authorized Official Name | DANIEL JAMES FAIR (ADMINISTRATOR) |
| Authorized Official Telephone | 7632414428 |
| Authorized Official Credential | DO |
| Is Organization Subpart | Y |
| Parent Organization Name | GUARDIAN ANGELS HEALTH SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MN DEPARTMENT OF HUMAN SERVICES | M112023900 | 01 |
| Other Name | Type Code |
|---|---|
| Angels On Main | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861499204 | Guardian Angels Health Services, Inc. | Skilled Nursing Facility | 400 Evans Avenue, Elk River, MN 55330-2604 | 2005-06-30 |
| Street Address |
9200 QUANTRELLE AVE NE |
| City | OTSEGO |
| State | MN |
| Zip Code | 55330-1048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932722584 | Evans Park, Inc | Assisted Living Facility | 9200 Quantrelle Ave Ne, Otsego, MN 55330-1048 | 2020-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710504139 | Jacob Stevens | Pharmacist | 19216 Freeport Ave, Cub Pharmacy, Elk River, MN 55330 | 2020-07-01 |
| 1578187456 | Coborns Inc | Pharmacy | 15700 88th St Ne, Otsego, MN 55330 | 2020-06-05 |
| 1346888609 | Katie Eberley | Counselor | 9425 Quantrelle Ave, Otsego, MN 55330 | 2019-12-18 |
| 1649839986 | Jodi Marie Pikula | Massage Therapist | 710 Dodge Ave, Suite C, Elk River, MN 55330 | 2019-06-11 |
| 1144793878 | Northern Cities Therapy, Inc. | Counselor | 19230 Evans St Nw Ste 100, Elk River, MN 55330 | 2019-01-04 |
| 1144715236 | Jennifer Kay Dahlseid | Chiropractor | 200 5th St Nw Ste J, Elk River, MN 55330 | 2018-06-29 |
| 1124542089 | Megan Majsterski Lazere | Counselor | 9245 Quantrelle Avenue, Otsego, MN 55330 | 2017-08-01 |
| 1134674237 | Rescare Minnesota | Community Based Residential Treatment Facility, Mental Illness | 633 Upland Ave Nw, Elk River, MN 55330 | 2016-08-18 |
| 1356894927 | Allison Benz | Counselor | 9245 Quantrelle Ave, Otsego, MN 55330 | 2016-07-29 |
| 1447615141 | Laura Stevenson | Speech-Language Pathologist | 15990 90th St., Otsego, MN 55330 | 2015-12-22 |
| Find all providers in zip 55330 | ||||
| Taxonomy Code | 261QA0600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Day Care |
| Definition to come... |
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| 1093347833 | Health Care Plus Inc. | Clinic/Center | 4949 Olson Memorial Hwy, Golden Valley, MN 55422-5130 | 2020-02-10 |
| 1932739570 | Care for You Inc | Clinic/Center | 2109 Nicollet Ave Ste 105, Minneapolis, MN 55404-3279 | 2020-01-23 |
| 1992342513 | The Salvation Army | Clinic/Center | 2080 Woodlynn Ave, Maplewood, MN 55109-1418 | 2019-12-02 |
| 1942844139 | Riverside Adult Care Inc | Clinic/Center | 924 19th Ave S Ste B, Minneapolis, MN 55404-2202 | 2019-10-31 |
| 1497397491 | Forever Friendship Adult Day Center | Clinic/Center | 734 Snelling Ave N, Saint Paul, MN 55104-2384 | 2019-10-10 |
| 1568013191 | Sip Brothers Inc. | Clinic/Center | 4618 85th Ave N, Brooklyn Park, MN 55443-1957 | 2019-09-25 |
| 1346709268 | State of Minnesota-minnesota Management and Budget | Clinic/Center | 5101 Minnehaha Ave Bldg 4, Minneapolis, MN 55417-1647 | 2019-03-19 |
| 1912475716 | B's Adult Day Center Inc | Clinic/Center | 626 Main Street North, Cambridge, MN 55008 | 2018-11-09 |
| Find all providers with the same taxonomy | ||||
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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.