MEDICARE: GUARDIAN DAY HEALTHCARE FOR SENIORS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770137572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN DAY HEALTHCARE FOR SENIORS LLC

Provider Business Mailing Address
First Line	:	2511 W CHURCH ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32805-2329
Country	:	US
Telephone Number	:	407-205-5142
Fax Number	:

Provider Business Practice Location Address
First Line	:	2511 W CHURCH ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32805-2329
Country	:	US
Telephone Number	:	407-205-5142
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS OFFICE MANAGER
Name	:	MARLA MONTFORD
Credential	:
Telephone Number	:	407-295-5371

Provider Enumeration Date	:	07/30/2019
Last Update Date	:	07/30/2019

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Directions to “GUARDIAN DAY HEALTHCARE FOR SENIORS LLC ” Practice Location

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