| NPI | 1336663442 |
|---|---|
| Other Name | SUBURBAN GUARDIANSHIP, LLC. |
| Entity Type | Organization |
| Authorized Contact | DESHAUN VRAIN CLARK Owner/CEO 704-918-4627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2017-07-31 |