Provider Demographics
NPI:1821748906
Name:GARNETT SENIOR SERVICES, LLC
Entity Type:Organization
Organization Name:GARNETT SENIOR SERVICES, LLC
Other - Org Name:ACTI-KARE WYTHEVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:GARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:276-620-6432
Mailing Address - Street 1:176 DAGGER LN
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-6068
Mailing Address - Country:US
Mailing Address - Phone:276-620-6432
Mailing Address - Fax:
Practice Address - Street 1:176 DAGGER LN
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-6068
Practice Address - Country:US
Practice Address - Phone:276-620-6432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care