Guardian Home Care of Northeast Georgia, LLC
Organization Active NPI Home Health Agency · Buford, GA
NPI 1639100985 · NPPES record last updated Dec 30, 2021
Key facts
- NPI
- 1639100985
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 069274H (GA)
- Legal business name
- GUARDIAN HOME CARE OF NORTHEAST GEORGIA, LLC
- Practice address
- 5089 Bristol Industrial Way Ste B
Buford, GA 30518-1780 - Phone
- (678) 450-9950
- Fax
- (678) 450-9930
- NPI assigned
- Jul 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Heather Siscel
- Title
- VP Legal
- Phone
- (224) 221-0465
Facilities with the same owner 114
Affiliated clinicians 149
-
Benjamin Abraham, DO
-
Taneisha Nacoya Benjamin, M.D.
-
Samantha Benson, M.D.
-
Richard E Blatt, M.D.
-
Benigno B Bobon, M.D.
-
Christopher Borrego, D.O.
-
C. Shane Bussler, M.D.
-
Paul Q. Cerny, M.D.
-
Biswashree Chaudhury, M.D.
-
Darrell Mark Cheek, M.D.
-
Sudha M Cheekati, M.D.
-
Kaavya Chivukula, MD
-
Holly Davidson Corley, M.D.
-
Robert T Dambach Jr., D.O.
-
Chase Stuart Dean, M.D.
-
Jigishu J Dhabuwala, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Accentcare Home Health of Northeast Georgia
- Overall star rating
- ★★★★☆ 4 of 5
- Ownership
- Proprietary
- Certified
- Nov 24, 2003
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D1018824 | Guardian Home Care of North East Georgia LLC | Certificate of waiver | Nov 2, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Home health agency certification: CCN 117139
- Legal name
- GUARDIAN HOME CARE OF NORTHEAST GEORGIA, LLC
- Doing business as
- ACCENTCARE HOME HEALTH OF NORTHEAST GEORGIA
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Nov 24, 2003
- Last certification
- Oct 31, 2019
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Nov 4, 2002 in GA
- Enrollment address
- 5089 Bristol Industrial Way
Ste B
Buford, GA 30518-1780
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Laura Tortorella |
Corporate Officer |
Dec 14, 2023 | |
| Advent International Gpe VIII-B, L.P. |
5% Or Greater Indirect Ownership Interest | Jun 20, 2019 | 15.1% |
| Horizon Acquisition Co Inc. |
5% Or Greater Indirect Ownership Interest | Jun 20, 2019 | 100% |
| Advent International Gpe VIII-H, L.P. |
5% Or Greater Indirect Ownership Interest | Jun 20, 2019 | 5.5% |
| Horizon Group Holdings Intermediate 2, Inc. |
5% Or Greater Indirect Ownership Interest | Jun 20, 2019 | 100% |
| Seasons Rollover Holdings LLC |
5% Or Greater Indirect Ownership Interest | Dec 21, 2020 | 15.4% |
| Guardian Home Care Holdings Inc |
5% Or Greater Direct Ownership Interest | May 5, 2006 | 100% |
| Horizon Group Holdings Intermediate 1, Inc. |
5% Or Greater Indirect Ownership Interest | Jun 20, 2019 | 100% |
| Advent International Gpe VIII-I, L.P. |
5% Or Greater Indirect Ownership Interest | Jun 20, 2019 | 5.1% |
| Horizon Group Holdings, L.P. |
5% Or Greater Indirect Ownership Interest | Jun 20, 2019 | 100% |
| Advent International Gpe VIII-J LP |
5% Or Greater Indirect Ownership Interest | Jun 20, 2019 | 5% |
| Advent International Gpe VIII-B-1, L.P. |
5% Or Greater Indirect Ownership Interest | Jun 20, 2019 | 5.4% |
| Mary Frances Perkins |
W-2 Managing Employee |
Jun 1, 2025 | |
| Advent International Gpe VIII-B-3, L.P. |
5% Or Greater Indirect Ownership Interest | Jun 20, 2019 | 6.3% |
| Advent International Gpe VIII-a LP |
5% Or Greater Indirect Ownership Interest | Jun 20, 2019 | 11.2% |
| Accentcare, Inc. |
5% Or Greater Indirect Ownership Interest | Dec 22, 2010 | 100% |
| Dena Schwartz-Doty |
Corporate Officer |
Apr 1, 2015 | |
| Pluto Acquisition I Inc |
5% Or Greater Indirect Ownership Interest | Dec 22, 2010 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030926000020 | GA | Part a Provider - Home Health Agency | 9638080617 | Practice locations: Buford, GA |
National Provider Directory
Locations
5089 Bristol Industrial Way
Ste B
Buford, GA 30518
Phone (678) 450-9950
501 Candler St
#B
Gainesville, GA 30501
Phone (678) 450-9950
701 Medical Park Ln
Gainesville, GA 30501
1174 McKendree Church Rd
Ste 202
Lawrenceville, GA 30043
Phone (770) 982-2231
2121 Fountain Dr
Ste H
Snellville, GA 30078
Phone (706) 870-3897
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 069274H | GA | Yes |
Addresses
Primary practice location
5089 Bristol Industrial Way Ste B
Buford, GA 30518-1780
Mailing address
5089 Bristol Industrial Way Ste B
Buford, GA 30518-1780
Phone (678) 450-9950
Other names
- AccentCare Home Health of Northeast Georgia
Other providers in Buford, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.