Healthcare Provider Details

I. General information

NPI: 1083221436
Provider Name (Legal Business Name): TBH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CENTERVIEW DR STE 300
GREENSBORO NC
27407-3712
US

IV. Provider business mailing address

3911 JACK PINE CT
GREENSBORO NC
27406-8765
US

V. Phone/Fax

Practice location:
  • Phone: 336-617-0469
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: GARVEY PRESLEY III
Title or Position: OWNER
Credential:
Phone: 336-617-0469