Provider Demographics
NPI:1427516970
Name:GUARDIAN - A PLACE TO CALL HOME, PCH
Entity type:Organization
Organization Name:GUARDIAN - A PLACE TO CALL HOME, PCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-686-3606
Mailing Address - Street 1:PO BOX 4601
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31604-4601
Mailing Address - Country:US
Mailing Address - Phone:229-686-3606
Mailing Address - Fax:844-272-8933
Practice Address - Street 1:310 W WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:GA
Practice Address - Zip Code:31639-2144
Practice Address - Country:US
Practice Address - Phone:229-686-3606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility