MY GUARDIAN ANGEL GROUP HOME – NPI #1376724039
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
MY GUARDIAN ANGEL GROUP HOME is a community based residential treatment facility located in ROCKY MOUNT, NC. NPPES has assigned the NPI number 1376724039 to MY GUARDIAN ANGEL GROUP HOME on November 21, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MY GUARDIAN ANGEL GROUP HOME” is a dba name, the actual legal business name for this organization is BRENDA W BRYAN. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.
The NPI profile was previously updated about 18 years ago on Aug 01, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MY GUARDIAN ANGEL GROUP HOME below.
NPI Profile for
BRENDA W BRYAN
(more than 18 years ago)
ROCKY MOUNT, NC 27801 Phone: (252) 977-1956 Fax: (252) 977-1956
OWNER
Phone: (252) 977-1956
Identifiers for MY GUARDIAN ANGEL GROUP HOME
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| MEDICAID | NC | 7805933 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary) |
NC | MHL033046 |
| 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
NC | MHL033046 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.