MEDICARE: FIRST GUARDIAN HEALTHCARE

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
3	253Z00000X	In Home Supportive Care Agency
4	313M00000X	Nursing Facility/Intermediate Care Facility
5	251S00000X	Community/Behavioral Health Agency
6	251J00000X	Nursing Care Agency
7	251E00000X	Home Health Agency
8	253J00000X	Foster Care Agency
9	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
10	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
11	347C00000X	Private Vehicle
12	252Y00000X	Early Intervention Provider Agency
13	385HR2065X	Child Physical Disabilities Respite Care
14	320700000X	Physical Disabilities Residential Treatment Facility
15	251C00000X	Developmentally Disabled Services Day Training Agency

NPI Number	:	1609739507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST GUARDIAN HEALTHCARE

Provider Business Mailing Address
First Line	:	835 MOUNTAIN AVE APT 26
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-3447
Country	:	US
Telephone Number	:	908-764-9617
Fax Number	:

Provider Business Practice Location Address
First Line	:	835 MOUNTAIN AVE APT 26
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-3447
Country	:	US
Telephone Number	:	908-764-9617
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	GREGY ALEXANDER
Credential	:
Telephone Number	:	908-764-9617

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

2101 E JEFFERSON ST , KAISER PERMANENTE SPRINGFIELD MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 701-922-1000
Practice Fax: 703-922-1039