Organization
GUARDIAN HAVEN ACADEMY
Active
Other names
Guardian Haven
Organization subpart
No
Provider details
NPI number
Authorized official
NAKISHA LAVELL VARLACK (OWNER)
(813) 400-2117
Entity
Organization
Contact information
Practice address
5806 BRECKENRIDGE PKWY STE B, TAMPA, FL 33610-4211
(813) 400-2117
Mailing address
7853 GUNN HWY # 109, TAMPA, FL 33626-1611
(813) 400-2117
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100069300
—
FL
Enumeration date
06/20/2018
Last updated
03/05/2025
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