Healthcare Provider Details

I. General information

NPI: 1053547265
Provider Name (Legal Business Name): TNTS ENTERPRISE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 WRENWOOD CT
GREENSBORO NC
27455-9211
US

IV. Provider business mailing address

1411 WRENWOOD CT
GREENSBORO NC
27455-9211
US

V. Phone/Fax

Practice location:
  • Phone: 336-254-2210
  • Fax:
Mailing address:
  • Phone: 336-254-2210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. TONYA M THOMPSON
Title or Position: CO-OWNER
Credential:
Phone: 336-254-2210