MEDICARE: TARIRO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1568223824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TARIRO LLC

Provider Business Mailing Address
First Line	:	24810 CREEK LN
Second Line	:
City	:	NORTH DINWIDDIE
State	:	VA
Zip	:	23803-8864
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	24810 CREEK LN
Second Line	:
City	:	NORTH DINWIDDIE
State	:	VA
Zip	:	23803-8864
Country	:	US
Telephone Number	:	804-252-0008
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	NEDEDRA WILLIAMS
Credential	:
Telephone Number	:	804-252-0008

Provider Enumeration Date	:	01/23/2024
Last Update Date	:	01/23/2024

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