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General NPI Number Information
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NPI Number | 1053864744
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Entity Type | Organization
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Legal Business Name | GUARDIANS BY THE SEA, INC.
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Dates
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Enumeration Date | 07/28/2016
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Last Update Date | 07/28/2016
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Provider Practice Location Address
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Address Line | 16210 E HOFFELDT LN SUITE #5
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City | BROOKINGS
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State | OR
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Zip | 97415-8403
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Country | US
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Telephone | 541-661-7011
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Fax | 541-813-1352
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Provider Business Mailing Address
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Address Line | PO BOX 7202
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City | BROOKINGS
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State | OR
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Zip | 97415-0334
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Country | US
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Telephone | 541-661-7011
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Fax | 541-813-1352
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | VICKIE LYNN HOWELL
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Credential |
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Telephone | 541-661-7011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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