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General NPI Number Information
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NPI Number | 1962999052
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Entity Type | Organization
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Legal Business Name | GUARDIAN HEALTH CARE SERVICES
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Dates
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Enumeration Date | 04/16/2018
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Last Update Date | 07/09/2021
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Provider Practice Location Address
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Address Line | 2902 S RENE DR
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City | SANTA ANA
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State | CA
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Zip | 92704-6222
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Country | US
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Telephone | 714-375-1110
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Fax |
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Provider Business Mailing Address
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Address Line | 16541 GOTHARD ST STE 102
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-4472
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Country | US
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Telephone | 714-375-1110
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Fax | 714-242-9700
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | BENJAMIN WOODFORD SMITH
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Credential |
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Telephone | 949-892-3020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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