MEDICARE: GUARDIAN HOMES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1194671172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN HOMES LLC

Provider Business Mailing Address
First Line	:	4230 N OAKLAND AVE STE 167
Second Line	:
City	:	SHOREWOOD
State	:	WI
Zip	:	53211-2042
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5605 W CUSTER AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-3236
Country	:	US
Telephone Number	:	414-416-2169
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SALONDA COLEMAN
Credential	:
Telephone Number	:	414-416-2169

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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Directions to “GUARDIAN HOMES LLC ” Practice Location

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