Provider Demographics
NPI:1871040931
Name:GUARDIAN HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:GUARDIAN HEALTH CARE SERVICES
Other - Org Name:D'AMORE HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:WOODFORD
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-892-3020
Mailing Address - Street 1:16541 GOTHARD STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4471
Mailing Address - Country:US
Mailing Address - Phone:714-375-1110
Mailing Address - Fax:
Practice Address - Street 1:1055 CHEYENNE STREET
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-2860
Practice Address - Country:US
Practice Address - Phone:714-375-1110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA306005925OtherCALIFORNIA DEPARTMENT OF SOCIAL SERVICES
CAMHBS210360OtherCALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES