Provider Demographics
NPI:1639409014
Name:GUARDIAN IN HOME HEALTH & SECURITY, LLC
Entity Type:Organization
Organization Name:GUARDIAN IN HOME HEALTH & SECURITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BORG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-864-6544
Mailing Address - Street 1:14907 125TH ST
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:MN
Mailing Address - Zip Code:55336-4613
Mailing Address - Country:US
Mailing Address - Phone:320-864-6544
Mailing Address - Fax:320-864-6544
Practice Address - Street 1:14907 125TH ST
Practice Address - Street 2:
Practice Address - City:GLENCOE
Practice Address - State:MN
Practice Address - Zip Code:55336-4613
Practice Address - Country:US
Practice Address - Phone:320-864-6544
Practice Address - Fax:320-864-6544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN345070251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health