Provider Demographics
NPI:1992993810
Name:GUARDIAN HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:GUARDIAN HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-930-5712
Mailing Address - Street 1:750 W CENTER ST FL 3
Mailing Address - Street 2:
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1545
Mailing Address - Country:US
Mailing Address - Phone:508-588-5811
Mailing Address - Fax:508-588-5221
Practice Address - Street 1:750 W CENTER ST FL 3
Practice Address - Street 2:
Practice Address - City:WEST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02379-1545
Practice Address - Country:US
Practice Address - Phone:508-588-5811
Practice Address - Fax:508-588-5221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0608645Medicaid
MA227504Medicare Oscar/Certification