Provider Demographics
NPI:1679360986
Name:GENTLE GUARDIAN HEALTH CARE
Entity type:Organization
Organization Name:GENTLE GUARDIAN HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WALTERINE
Authorized Official - Middle Name:LUREISHA
Authorized Official - Last Name:BURROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-680-0085
Mailing Address - Street 1:304 S JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-2623
Mailing Address - Country:US
Mailing Address - Phone:470-789-7861
Mailing Address - Fax:
Practice Address - Street 1:116 TUXWORTH CIR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5615
Practice Address - Country:US
Practice Address - Phone:470-789-7861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health