Provider Demographics
NPI:1619256740
Name:MY GUARDIAN FOR LIFE, INC.
Entity Type:Organization
Organization Name:MY GUARDIAN FOR LIFE, INC.
Other - Org Name:MY GUARDIAN FOR LIFE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEILERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-500-6332
Mailing Address - Street 1:761 JUSTIN RD STE G
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-4876
Mailing Address - Country:US
Mailing Address - Phone:972-722-7490
Mailing Address - Fax:972-722-7403
Practice Address - Street 1:761 JUSTIN RD STE G
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-4876
Practice Address - Country:US
Practice Address - Phone:972-722-7490
Practice Address - Fax:972-722-7403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-07
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based