Provider Demographics
NPI:1033933676
Name:GUARDIAN HOME CARE OF KS LLC
Entity type:Organization
Organization Name:GUARDIAN HOME CARE OF KS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAIGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-315-6066
Mailing Address - Street 1:8 TROTTERS WAY
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4490
Mailing Address - Country:US
Mailing Address - Phone:917-690-6854
Mailing Address - Fax:
Practice Address - Street 1:205 W CRESTWAY AVE STE 300
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-1854
Practice Address - Country:US
Practice Address - Phone:316-315-6066
Practice Address - Fax:316-315-6067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult Companion