Healthcare Provider Details

I. General information

NPI: 1497315832
Provider Name (Legal Business Name): GUARDIAN CARE ADVISORS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 10/26/2022
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 ASHLEY SQ
WINSTON SALEM NC
27103-2919
US

IV. Provider business mailing address

1320 ASHLEY SQ
WINSTON SALEM NC
27103-2919
US

V. Phone/Fax

Practice location:
  • Phone: 336-462-8472
  • Fax: 336-793-9585
Mailing address:
  • Phone: 336-462-8472
  • Fax: 336-793-9585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. NORMAN DAVID POTTER JR.
Title or Position: EXECUTIVE DIRECTOR AND CO-OWNER
Credential: ADMINISTRATOR
Phone: 336-462-8472