Provider Demographics
NPI:1255030235
Name:GUARDIAN LIGHT HOME HEALTH LLC
Entity type:Organization
Organization Name:GUARDIAN LIGHT HOME HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOLLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-267-7746
Mailing Address - Street 1:733 THIMBLE SHOALS BLVD STE 170
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4260
Mailing Address - Country:US
Mailing Address - Phone:252-267-7746
Mailing Address - Fax:
Practice Address - Street 1:733 THIMBLE SHOALS BLVD STE 207
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4260
Practice Address - Country:US
Practice Address - Phone:252-267-7746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty