Healthcare Provider Details

I. General information

NPI: 1760268635
Provider Name (Legal Business Name): GUARDIAN CARE LC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 N WATER ST STE 400
MILWAUKEE WI
53202-2603
US

IV. Provider business mailing address

1433 N WATER ST STE 400
MILWAUKEE WI
53202-2603
US

V. Phone/Fax

Practice location:
  • Phone: 414-208-3052
  • Fax:
Mailing address:
  • Phone: 414-208-3052
  • Fax:

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
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: JUSTICE MEEKS
Title or Position: OWNER
Credential:
Phone: 414-581-2418