Provider Demographics
NPI:1861632580
Name:A GUARDIAN ANGEL CASE MANAGEMENT, LLC
Entity type:Organization
Organization Name:A GUARDIAN ANGEL CASE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED CASE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BERNADINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:615-289-5002
Mailing Address - Street 1:4405 SUMMERTIME DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-1061
Mailing Address - Country:US
Mailing Address - Phone:615-289-5002
Mailing Address - Fax:615-876-7369
Practice Address - Street 1:4405 SUMMERTIME DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-1061
Practice Address - Country:US
Practice Address - Phone:615-289-5002
Practice Address - Fax:615-876-7369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-21
Last Update Date:2009-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPENDING251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management