Healthcare Provider Details

I. General information

NPI: 1396391082
Provider Name (Legal Business Name): GUY CARE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2019
Last Update Date: 08/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

548 CEDARMONT DR
ANTIOCH TN
37013-4428
US

IV. Provider business mailing address

548 CEDARMONT DR
ANTIOCH TN
37013-4428
US

V. Phone/Fax

Practice location:
  • Phone: 615-928-8280
  • Fax: 615-679-0873
Mailing address:
  • Phone: 615-928-8280
  • Fax: 615-679-0873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: DANETT VERONICA GUY
Title or Position: OWNER/OPERATOR
Credential: RN
Phone: 914-589-2568