Organization
GUARDIAN COMMUNITY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENNETTA TAMARA NELSON BSN,RN (OWNER/ADMINISTRATOR)
(919) 358-2797
Entity
Organization
Contact information
Practice address
101 FOREST DR STE B, KNIGHTDALE, NC 27545-9603
(919) 358-2797
Mailing address
PO BOX 1482, KNIGHTDALE, NC 27545-1482
(919) 358-2797
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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