Provider Demographics
NPI:1053864744
Name:GUARDIANS BY THE SEA, INC.
Entity Type:Organization
Organization Name:GUARDIANS BY THE SEA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-661-7011
Mailing Address - Street 1:PO BOX 7202
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-0334
Mailing Address - Country:US
Mailing Address - Phone:541-661-7011
Mailing Address - Fax:541-813-1352
Practice Address - Street 1:16210 E HOFFELDT LN
Practice Address - Street 2:SUITE #5
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415-8403
Practice Address - Country:US
Practice Address - Phone:541-661-7011
Practice Address - Fax:541-813-1352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care