Provider Demographics
NPI:1932500048
Name:GUARDIAN CARE OF TN HOMECARE
Entity Type:Organization
Organization Name:GUARDIAN CARE OF TN HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-896-4668
Mailing Address - Street 1:4821 AMERICAN WAY STE 300A
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-2454
Mailing Address - Country:US
Mailing Address - Phone:901-421-5238
Mailing Address - Fax:
Practice Address - Street 1:4821 AMERICAN WAY STE 300A
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-2454
Practice Address - Country:US
Practice Address - Phone:901-421-5238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1000000015175251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health