| Imperial Guardian Llc | |
|
2257 Clara Kee Blvd Tallahassee FL 32303-7135 | |
| (850) 692-4300 | |
| (850) 668-5679 |
| Full Name | Imperial Guardian Llc |
|---|---|
| Speciality | Home Health Aide |
| Location | 2257 Clara Kee Blvd, Tallahassee, Florida |
| Authorized Official Name and Position | Annie Odom (OWNER) |
| Authorized Official Contact | 8506924300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imperial Guardian Llc 2413 Raymond Diehl Rd Apt 2 Tallahassee FL 32309-3628 Ph: (850) 692-4300 | Imperial Guardian Llc 2257 Clara Kee Blvd Tallahassee FL 32303-7135 Ph: (850) 692-4300 |
| NPI Number | 1962112060 |
|---|---|
| Provider Enumeration Date | 11/29/2022 |
| Last Update Date | 07/10/2023 |
| Certification Date | 07/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962112060 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 374U00000X | Home Health Aide | (* (Not Available)) | Primary |
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