Provider Demographics
NPI:1396391082
Name:GUY CARE SERVICE
Entity Type:Organization
Organization Name:GUY CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANETT
Authorized Official - Middle Name:VERONICA
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:914-589-2568
Mailing Address - Street 1:548 CEDARMONT DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4428
Mailing Address - Country:US
Mailing Address - Phone:615-928-8280
Mailing Address - Fax:615-679-0873
Practice Address - Street 1:548 CEDARMONT DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-4428
Practice Address - Country:US
Practice Address - Phone:615-928-8280
Practice Address - Fax:615-679-0873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-17
Last Update Date:2019-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ049410Medicaid