Provider Demographics
NPI:1770073082
Name:GUARDIAN HOME COMPANION SERVICES, LLC
Entity type:Organization
Organization Name:GUARDIAN HOME COMPANION SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:HHA
Authorized Official - Phone:929-296-0363
Mailing Address - Street 1:7704 KNEELAND AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4102
Mailing Address - Country:US
Mailing Address - Phone:929-296-0363
Mailing Address - Fax:929-296-0363
Practice Address - Street 1:7704 KNEELAND AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4102
Practice Address - Country:US
Practice Address - Phone:929-296-0363
Practice Address - Fax:929-296-0363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care