Healthcare Provider Details

I. General information

NPI: 1295059764
Provider Name (Legal Business Name): TTJ MEDSTAFF STAFFING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2010
Last Update Date: 03/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3780 OLD NORCROSS RD STE 103-275
DULUTH GA
30096-1740
US

IV. Provider business mailing address

2542 YOUNG AMERICA DR
LAWRENCEVILLE GA
30043-8002
US

V. Phone/Fax

Practice location:
  • Phone: 877-452-7954
  • Fax: 404-751-2787
Mailing address:
  • Phone: 877-453-7954
  • Fax: 404-751-2787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2010007122
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number2010007122
License Number StateGA

VIII. Authorized Official

Name: TRACEY TURNER JANT
Title or Position: CEO/OWNER
Credential:
Phone: 877-453-7954