Provider Demographics
NPI:1821536046
Name:GUARDIAN HOME CARE SERVICES,LLC
Entity Type:Organization
Organization Name:GUARDIAN HOME CARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:904-572-2162
Mailing Address - Street 1:50 N LAURA ST STE 2500
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-3646
Mailing Address - Country:US
Mailing Address - Phone:904-572-2162
Mailing Address - Fax:
Practice Address - Street 1:50 N LAURA ST STE 2500
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-3646
Practice Address - Country:US
Practice Address - Phone:904-572-2162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-08
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X, 372600000X
FL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104508700Medicaid