WILLOW ROAD FACILITY
NPI 1720136963
Community/Behavioral Health in Macon, NC
About Willow Road Facility NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WILLOW ROAD FACILITY (NPI 1720136963) is a healthcare organization registered as a community/behavioral health in Macon, North Carolina and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through February 4, 2028 and lists Cornelius Williams, President Registered Agent, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 34D2338159
Willow Road Facility · Macon, NCOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MACON, NC 27551
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Guardian Angel Healthcare's NPI number?
The NPI number for Guardian Angel Healthcare is 1720136963. It was assigned to this organization in the NPPES registry on January 6, 2007. The provider is doing business as Willow Road Facility.
Where is Guardian Angel Healthcare located?
Guardian Angel Healthcare is located at 474 Macon Embro Rd, Macon, NC 27551. The listed phone number is (252) 257-1380.
What is Guardian Angel Healthcare's specialty?
The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.
Does Guardian Angel Healthcare hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 34D2338159) is associated with this NPI, valid through February 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Guardian Angel Healthcare was last updated on September 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Willow Road Facility · NPI 1720136963
Community/Behavioral Health organization in Macon, North Carolina. Organization record, active in the CMS NPPES registry since January 6, 2007.
## Identity
- **NPI:** 1720136963 (Entity type: Organization)
- **Enumerated:** January 6, 2007
- **Primary specialty:** Community/Behavioral Health · taxonomy 251S00000X
- **Legal business name:** Guardian Angel Healthcare
- **Organization subpart:** No
- **Authorized official:** Cornelius Williams, PRESIDENT REGISTERED AGENT
## Practice location
- **Address:** 474 MACON EMBRO RD, Macon, NC 27551-9285
- **Phone:** (252) 257-1380
## Record status
- **NPPES last updated:** September 25, 2021
- **Other identifiers:** Medicaid 7804755 (NC)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1720136963) · Data from the CMS NPPES public registry.