Provider Demographics
NPI:1043460298
Name:PATRICIA GARRETT
Entity Type:Organization
Organization Name:PATRICIA GARRETT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPONSOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-907-5207
Mailing Address - Street 1:3140 S TOBIN CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-1888
Mailing Address - Country:US
Mailing Address - Phone:480-907-5207
Mailing Address - Fax:
Practice Address - Street 1:3140 S TOBIN CIR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-1888
Practice Address - Country:US
Practice Address - Phone:480-907-5207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH3123385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care