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General NPI Number Information
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NPI Number | 1265842280
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Entity Type | Organization
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Legal Business Name | GUARDIAN OF HOPE SENIOR HOME, LLC
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 2900 14TH N SUITE 3A
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City | NAPLES
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State | FL
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Zip | 34103
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Country | US
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Telephone | 239-263-7548
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Fax | 239-263-7548
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Provider Business Mailing Address
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Address Line | 2900 14TH ST N STE 3A
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City | NAPLES
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State | FL
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Zip | 34103-4507
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Country | US
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Telephone | 239-263-7548
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Fax | 239-263-7548
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Authorized Official
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Title or Position | OWNER
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Name | VERONICA R THIBEAU
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Credential | HHA CERTIFIED
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Telephone | 239-263-7548
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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 | 233483
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License Number State | FL
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