# GUARDIAN MANOR LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043055510
- **Authorized official:** HANNA GIZAW (PROVIDER)
- **Authorized official phone:** (206) 229-0754

## Contact information

- **Practice address:** 23105 53RD AVE W, MOUNTLAKE TERRACE, WA 98043-4703
- **Practice address phone:** (206) 229-0754
- **Mailing address:** 23105 53RD AVE W, MOUNTLAKE TERRACE, WA 98043-4703
- **Mailing address phone:** (206) 229-0754

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 06/27/2024
- **Last updated:** 06/27/2024