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General NPI Number Information
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NPI Number | 1679360986
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Entity Type | Organization
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Legal Business Name | GENTLE GUARDIAN HEALTH CARE
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 116 TUXWORTH CIR
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City | DECATUR
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State | GA
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Zip | 30033-5615
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Country | US
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Telephone | 470-789-7861
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Fax |
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Provider Business Mailing Address
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Address Line | 304 S JONES BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89107-2623
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Country | US
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Telephone | 470-789-7861
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. WALTERINE LUREISHA BURROW
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Credential |
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Telephone | 323-680-0085
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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 |
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License Number State |
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