Provider Demographics
NPI:1679890685
Name:GUARDIAN HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:GUARDIAN HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:DON
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:801-699-5219
Mailing Address - Street 1:8649 S 1300 E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-1909
Mailing Address - Country:US
Mailing Address - Phone:801-446-5871
Mailing Address - Fax:801-446-5872
Practice Address - Street 1:8649 S 1300 E
Practice Address - Street 2:SUITE 100
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-1909
Practice Address - Country:US
Practice Address - Phone:801-446-5871
Practice Address - Fax:801-446-5872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
467315Medicare Oscar/Certification