Provider Demographics
NPI:1407238355
Name:GUARDIAN CARE ADVISORS, INC.
Entity Type:Organization
Organization Name:GUARDIAN CARE ADVISORS, INC.
Other - Org Name:GRISWOLD HOME CARE OF WINSTON SALEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-462-8472
Mailing Address - Street 1:1320 ASHLEY SQ
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-2919
Mailing Address - Country:US
Mailing Address - Phone:336-462-8472
Mailing Address - Fax:
Practice Address - Street 1:1320 ASHLEY SQ
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2919
Practice Address - Country:US
Practice Address - Phone:336-462-8472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-26
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4488311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC4488OtherDEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF HEALTH SERVICE REGULATION