1265450993 NPI number — DEL NORTE HOME CARE LLC DBA GUARDIAN ANGEL HOME HEALTHCARE SERVICES

Table of content: (NPI 1265450993)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265450993 NPI number — DEL NORTE HOME CARE LLC DBA GUARDIAN ANGEL HOME HEALTHCARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEL NORTE HOME CARE LLC DBA GUARDIAN ANGEL HOME HEALTHCARE SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
GUARDIAN ANGEL HOME HEALTHCARE SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265450993
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1537 N ZARAGOZA RD STE 2A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79936-8095
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-594-1116
Provider Business Mailing Address Fax Number:
915-849-7825

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1537 N ZARAGOZA RD STE 2A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79936-8095
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-594-1116
Provider Business Practice Location Address Fax Number:
915-849-7825
Provider Enumeration Date:
07/18/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
IKE
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CEO CFO
Authorized Official Telephone Number:
915-594-1116

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  002386 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 011677 . This is a "TEXAS HEALTH AND HUMAN SERVICES COMMISSION" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 024682901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".