Provider Demographics
NPI:1508994278
Name:GUARDIAN HOME HEALTH CARE
Entity Type:Organization
Organization Name:GUARDIAN HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LAQUINSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-234-3110
Mailing Address - Street 1:5930 PRESTON VIEW BLVD
Mailing Address - Street 2:STE. J140
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-4766
Mailing Address - Country:US
Mailing Address - Phone:972-234-3110
Mailing Address - Fax:972-234-2515
Practice Address - Street 1:5930 PRESTON VIEW BLVD
Practice Address - Street 2:STE. J140
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4766
Practice Address - Country:US
Practice Address - Phone:972-234-3110
Practice Address - Fax:972-234-2515
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOELLEN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-02
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010444251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679328Medicare Oscar/Certification