Provider Demographics
NPI:1316291727
Name:GUARDIAN HEALTHCARE PROVIDERS INC
Entity type:Organization
Organization Name:GUARDIAN HEALTHCARE PROVIDERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RENAE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGREGOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-377-9140
Mailing Address - Street 1:105 WESTPARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5319
Mailing Address - Country:US
Mailing Address - Phone:615-377-9140
Mailing Address - Fax:615-661-6011
Practice Address - Street 1:105 WESTPARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5319
Practice Address - Country:US
Practice Address - Phone:615-377-9140
Practice Address - Fax:615-661-6011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty