Provider Demographics
NPI:1427697309
Name:VET LIFE REHABS,LLC
Entity type:Organization
Organization Name:VET LIFE REHABS,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAVETTE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELOR SCICENCE
Authorized Official - Phone:310-384-3190
Mailing Address - Street 1:1907 ORVID ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-8037
Mailing Address - Country:US
Mailing Address - Phone:310-384-3190
Mailing Address - Fax:310-384-3191
Practice Address - Street 1:1907 ORVID ST
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8037
Practice Address - Country:US
Practice Address - Phone:310-384-3190
Practice Address - Fax:310-384-3191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-25
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health