Provider Demographics
NPI:1366894594
Name:GUARDIAN HOME CARE, INC
Entity type:Organization
Organization Name:GUARDIAN HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:GEME
Authorized Official - Last Name:ADDISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-744-7139
Mailing Address - Street 1:37 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47346-1212
Mailing Address - Country:US
Mailing Address - Phone:765-744-7139
Mailing Address - Fax:765-530-8143
Practice Address - Street 1:37 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:IN
Practice Address - Zip Code:47346-1212
Practice Address - Country:US
Practice Address - Phone:765-744-7139
Practice Address - Fax:765-530-8143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN15-013768-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health