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Organization

IMPERIAL GUARDIAN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANNIE ODOM (OWNER)
(850) 692-4300
Entity
Organization

Contact information

Practice address
2257 CLARA KEE BLVD, TALLAHASSEE, FL 32303-7135
(850) 692-4300
(850) 668-5679
Mailing address
2413 RAYMOND DIEHL RD APT 2, TALLAHASSEE, FL 32309-3628
(850) 692-4300
(850) 668-8329

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
374U00000X
Home Health Aide
Primary

Other

Enumeration date
11/29/2022
Last updated
07/10/2023
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