Willow Road Facility

LBN: Guardian Angel Healthcare
Willow Road Facility is an health care organization with primary practice located at 474 Macon Embro Rd , Macon NC 27551-9285. The organization recently has 2 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Agencies / Community/Behavioral Health is the primary health care specialty. Guardian Angel Healthcare can be contacted via phone (252) 257-1380, or through Williams, Cornelius via phone (252) 204-1381.

Contact Information

Primary practice address
474 Macon Embro Rd Macon NC 27551-9285
Phone: (252) 257-1380
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Williams, Cornelius
Phone: (252) 204-1381

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X MHL093034 North Carolina

Profile Details

NPI number 1720136963
LBN Legal business name Guardian Angel Healthcare
DBA Doing business as Willow Road Facility
Authorized official Williams, Cornelius
Entity Organization
Organization subpart 1 No
Enumeration date Jan 6th, 2007
Last updated Sep 25th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720136963 NPPES
North Carolina MEDICAID 7804755

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