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NPI Code Detail

MEDICARE: JADY GAURDIAN LLC

MEDICARE: JADY GAURDIAN 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
1313M00000XNursing Facility/Intermediate Care Facility

General Provider Information

NPI Number : 1366164683
Entity Type Code : Organization
Provider Name (Legal Business Name) : JADY GAURDIAN LLC
Provider Business Mailing Address
First Line : 4302 E 14TH ST
Second Line :
City : TUCSON
State : AZ
Zip : 85711-4212
Country : US
Telephone Number : 480-452-8260
Fax Number :
Provider Business Practice Location Address
First Line : 4302 E 14TH ST
Second Line :
City : TUCSON
State : AZ
Zip : 85711-4212
Country : US
Telephone Number : 480-452-8260
Fax Number :
Authorized Official
Title or Position : CFO
Name : JEANETTE BOIT-KANIA
Credential :
Telephone Number : 763-498-1172
Provider Enumeration Date : 09/13/2022
Last Update Date : 09/13/2022

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Directions to “JADY GAURDIAN LLC ” Practice Location

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