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General NPI Number Information
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NPI Number | 1144540410
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Entity Type | Organization
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Legal Business Name | GUARDIAN HOME HEALTH, LLC
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 1521 S 3RD ST LOWER LEVEL
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City | TERRE HAUTE
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State | IN
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Zip | 47802-1011
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Country | US
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Telephone | 812-917-5249
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Fax | 812-917-5042
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Provider Business Mailing Address
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Address Line | 1521 S 3RD ST LOWER LEVEL
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City | TERRE HAUTE
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State | IN
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Zip | 47802-1011
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Country | US
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Telephone | 812-917-5249
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Fax | 812-917-5042
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOANNE MAE KENWORTHY
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Credential | RN
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Telephone | 812-917-5249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 10-012338-1
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License Number State | IN
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