Provider Demographics
NPI:1326576596
Name:GUARDIAN PROFESSIONAL SERVICES
Entity Type:Organization
Organization Name:GUARDIAN PROFESSIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:I
Authorized Official - Last Name:OLANIYI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-219-4522
Mailing Address - Street 1:3115 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2901
Mailing Address - Country:US
Mailing Address - Phone:301-219-4522
Mailing Address - Fax:
Practice Address - Street 1:3115 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2901
Practice Address - Country:US
Practice Address - Phone:301-219-4522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN62282251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management