- Enrollment id
- O20051011001096
- Enrollment state
- TN
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1124059407
- Multiple npi flag
- N
- Ccn
- 447559
- Associate id
- 3678598323
- Organization name
- GUARDIAN HOME CARE, LLC
- Doing business as name
- ACCENTCARE HOME HEALTH OF TENNESEE
- Incorporation date
- 2001-02-14
- Incorporation state
- TN
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 6116 SHALLOWFORD RD
- Address line 2
- STE 114
- City
- CHATTANOOGA
- State
- TN
- Zip code
- 374217202