Healthcare Provider Details
I. General information
NPI: 1598205353
Provider Name (Legal Business Name): GUARDIAN HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2017
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8408 SIX FORKS RD STE 102
RALEIGH NC
27615-3077
US
IV. Provider business mailing address
PO BOX 40367
RALEIGH NC
27629-0367
US
V. Phone/Fax
- Phone: 919-426-1653
- Fax: 919-424-7578
- Phone: 919-426-1653
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | HC4875 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | HC4875 |
| License Number State | NC |
VIII. Authorized Official
Name: MR.
ONYE
PAUL
ONUOHA
Title or Position: PRESIDENT
Credential:
Phone: 919-426-1653