MEDICARE: GUARDIAN EYES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency
3	251C00000X	Developmentally Disabled Services Day Training Agency	OH

General Provider Information

NPI Number	:	1336496181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN EYES LLC

Provider Business Mailing Address
First Line	:	2708 EASTON ST NE
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44721-2601
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2708 EASTON ST NE
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44721-2601
Country	:	US
Telephone Number	:	330-495-6187
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JESSICA LYNN BROWN
Credential	:
Telephone Number	:	330-495-6187

Provider Enumeration Date	:	08/11/2012
Last Update Date	:	03/06/2013

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Directions to “GUARDIAN EYES LLC ” Practice Location

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