Healthcare Provider Details

I. General information

NPI: 1497344105
Provider Name (Legal Business Name): THREE T'S HOME SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2021
Last Update Date: 01/16/2021
Certification Date: 01/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 S MILL CREEK CT
WOODSTOCK GA
30188-1740
US

IV. Provider business mailing address

116 S MILL CREEK CT
WOODSTOCK GA
30188-1740
US

V. Phone/Fax

Practice location:
  • Phone: 678-349-4079
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TYLER ROSE
Title or Position: OWNER
Credential:
Phone: 678-349-4079