- Enrollment id
- O20210913003468
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1881206472
- Multiple npi flag
- N
- Ccn
- 748075
- Associate id
- 2567868797
- Organization name
- GUARDIAN HOME CARE LLC
- Incorporation date
- 2020-03-10
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 612 W NOLANA AVE
- Address line 2
- STE 570B
- City
- MCALLEN
- State
- TX
- Zip code
- 785043971