NPI 1518457209
Guardian Angels Supported Living LLC
Practice location
- Address
- 1006 Linn St, Sikeston, MO 63801-2223
- Phone
- (573) 471-1412
- Fax
- (573) 481-4432
Authorised official
- Name
- Carrie Hardaway
- Title
- Ceo
- Phone
- (573) 575-1015
Registered specialties
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
Registry record
- NPI
- 1518457209
- Entity type
- Organization
- NPI issued
- 17 May 2018
- Record last updated
- 1 May 2019
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.