Guardian Manor LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

GUARDIAN MANOR LLC

Practice address

23105 53Rd Ave W
Mountlake Terrace, WA 98043-4703

Phone

(206) 229-0754

NPI assigned

Jun 27, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Hanna Gizaw

Title

Provider

Phone

(206) 229-0754

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1043055510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23105 53RD AVE W",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980434703",
            "telephone_number": "206-229-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23105 53RD AVE W",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980434703",
            "telephone_number": "206-229-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "GIZAW",
        "authorized_official_first_name": "HANNA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "206-229-0754"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Greiner
• Paige Gresens
• Audrey Katherine Grettie, LMHC, SUDP, CN, LMT
• Tyler Joseph Griffith, CPHT
• Anne Catherine Grisham-Pleas, LMHC, CDP
• Guardian Pharmacy of Washington, LLC (Mercury Pharmacy Services)
• Terrell Gunter, LMSW
• Lorine Guzman, MS
• Lynn Hackstaff, LICSW
• Krista Lynn Haglund, R.PH.

• Adult Care Home Facility in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.