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General NPI Number Information
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NPI Number | 1114708575
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Entity Type | Organization
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Legal Business Name | GUARDIANSHIP SERVICES INC
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Dates
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Enumeration Date | 10/11/2023
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 1125 COLLEGE AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-4514
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Country | US
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Telephone | 817-921-0499
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11481
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City | FORT WORTH
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State | TX
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Zip | 76110-0481
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Country | US
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Telephone | 817-921-0499
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LYN SCOTT
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Credential |
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Telephone | 817-921-0499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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