| NPI | 1376724039 |
|---|---|
| Doing Business As | MY GUARDIAN ANGEL GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | BRENDA BRYANT Owner 252-977-1956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL033046) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL033046) |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2008-08-01 |