Provider Demographics
NPI:1467178483
Name:GUARDIAN HALO HEALTH CARE INC
Entity Type:Organization
Organization Name:GUARDIAN HALO HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:O
Authorized Official - Last Name:MADOJEMU
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NIH, PHD
Authorized Official - Phone:757-215-5928
Mailing Address - Street 1:15196 CUMBERLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-0000
Mailing Address - Country:US
Mailing Address - Phone:757-215-5928
Mailing Address - Fax:
Practice Address - Street 1:15196 CUMBERLAND ROAD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-0000
Practice Address - Country:US
Practice Address - Phone:757-215-5928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care