Healthcare Provider Details
I. General information
NPI: 1265792592
Provider Name (Legal Business Name): ONE STOP TSC SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2012
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
965 MAIN ST
STONE MOUNTAIN GA
30083-2989
US
IV. Provider business mailing address
965 MAIN ST
STONE MOUNTAIN GA
30083-2989
US
V. Phone/Fax
- Phone: 770-469-7511
- Fax:
- Phone: 770-469-7511
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VANESSA
MCMILLEN
Title or Position: OWNER
Credential:
Phone: 678-791-6816