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General NPI Number Information
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NPI Number | 1164882254
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Entity Type | Organization
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Legal Business Name | GUARDIAN HOME CARE
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 3560 BRIDGEPORT WAY W SUITE 3-A
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4446
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Country | US
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Telephone | 253-881-0014
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Fax | 253-320-7440
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Provider Business Mailing Address
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Address Line | 3560 BRIDGEPORT WAY W SUITE 3-A
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4446
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Country | US
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Telephone | 253-881-0014
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Fax | 253-320-7440
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MRS. PAULETTE M GERSHICK
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Credential |
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Telephone | 253-881-0014
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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 | 603163787
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License Number State | WA
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