| Guardian Angel Healthcare Ii, Inc | |
|
347 Magnolia Drive Raleigh MS 39153 | |
| (601) 782-9997 | |
| (601) 732-8037 |
| Full Name | Guardian Angel Healthcare Ii, Inc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 347 Magnolia Drive, Raleigh, Mississippi |
| Authorized Official Name and Position | Paulette H Butler (CEO) |
| Authorized Official Contact | 6017829997 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Guardian Angel Healthcare Ii, Inc 41 S Hall Rd Morton MS 39117-8057 Ph: (601) 782-9997 | Guardian Angel Healthcare Ii, Inc 347 Magnolia Drive Raleigh MS 39153 Ph: (601) 782-9997 |
| NPI Number | 1285967653 |
|---|---|
| Provider Enumeration Date | 09/16/2009 |
| Last Update Date | 02/07/2022 |
| Certification Date | 02/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285967653 | NPI | - | NPPES |
| 25-S163 | Other | MS | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 16-255 (Mississippi) | Primary |
Region Ten Commission On Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 355 Hwy 37 South, Raleigh, MS 39153 Phone: 601-782-9461 |