Provider Demographics
NPI:1487799458
Name:GUARDIAN CARE HOME HEALTH AGENCY, INC.
Entity type:Organization
Organization Name:GUARDIAN CARE HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHAHRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BAVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-679-1010
Mailing Address - Street 1:9950 WESTPARK DR STE 103D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5379
Mailing Address - Country:US
Mailing Address - Phone:713-434-6289
Mailing Address - Fax:832-991-8869
Practice Address - Street 1:9950 WESTPARK DR STE 103D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063
Practice Address - Country:US
Practice Address - Phone:713-434-6289
Practice Address - Fax:832-991-8869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX678238251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX678238Medicare Oscar/Certification
TX678238Medicare UPIN