Provider Demographics
NPI:1457179517
Name:GUARDIAN HOME CARE OF MICHIGAN LLC
Entity type:Organization
Organization Name:GUARDIAN HOME CARE OF MICHIGAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JARBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-719-9082
Mailing Address - Street 1:5982 KINGSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1464
Mailing Address - Country:US
Mailing Address - Phone:248-719-9082
Mailing Address - Fax:
Practice Address - Street 1:5982 KINGSFIELD DR
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-1464
Practice Address - Country:US
Practice Address - Phone:248-719-9082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care