Provider Demographics
NPI:1285422089
Name:GUARDIAN 4 HEROES
Entity type:Organization
Organization Name:GUARDIAN 4 HEROES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/EXC DIRECTOR/FACILITATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:AMANDA
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:EFPT EQUINE THERAPY
Authorized Official - Phone:320-828-2477
Mailing Address - Street 1:24 FAIRY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SAUK CENTRE
Mailing Address - State:MN
Mailing Address - Zip Code:56378-1901
Mailing Address - Country:US
Mailing Address - Phone:320-828-2477
Mailing Address - Fax:
Practice Address - Street 1:310 US 71 N
Practice Address - Street 2:
Practice Address - City:SAUK CENTRE
Practice Address - State:MN
Practice Address - Zip Code:56378-1144
Practice Address - Country:US
Practice Address - Phone:320-828-2477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health