Healthcare Provider Details

I. General information

NPI: 1730007501
Provider Name (Legal Business Name): GUARDIAN GRACE HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 SULGRAVE CT
STERLING VA
20165-6406
US

IV. Provider business mailing address

123 SULGRAVE CT
STERLING VA
20165-6406
US

V. Phone/Fax

Practice location:
  • Phone: 571-682-4398
  • Fax:
Mailing address:
  • Phone: 571-682-4398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: KOFI OPOKU
Title or Position: GENERAL MANAGER
Credential:
Phone: 571-682-4398