Guardian Angels Supported Living LLC

NPI #1518457209 in Sikeston, Missouri

Provider Information

NPI Number: 1518457209
Entity Type: Organization
Organization Name: Guardian Angels Supported Living LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: May 17, 2018
Last Updated: May 1, 2019

Practice Location

Address: 1006 LINN ST
City: Sikeston
State: Missouri
ZIP Code: 63801-2223
Phone: (573) 471-1412

Authorized Official

Name: CARRIE HARDAWAY, LPN
Title: CEO
Phone: (573) 575-1015

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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