Organization
GUARDIANCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAUN TIERRE SMART (OWNER/CEO)
(614) 436-8500
Entity
Organization
Contact information
Practice address
8273 PARORI LN, BLACKLICK, OH 43004-8423
(614) 436-8500
(614) 569-0250
Mailing address
8273 PARORI LANE, BLACKLICK, OH 43004
(614) 436-8500
(614) 569-0250
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2547579
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2920129
—
OH
Enumeration date
06/23/2015
Last updated
07/08/2015
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