Healthcare Provider Details

I. General information

NPI: 1205210465
Provider Name (Legal Business Name): TOSH HEALTH SERVICES LLC DBA STRATFORD ADULT DAYCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3921 CAMERON CREEK DR
MATTHEWS NC
28105-6772
US

IV. Provider business mailing address

3921 CAMERON CREEK DR
MATTHEWS NC
28105-6772
US

V. Phone/Fax

Practice location:
  • Phone: 704-604-5677
  • Fax:
Mailing address:
  • Phone: 704-604-5677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. RONNIE EDOSOMWAN
Title or Position: DIRECTOR
Credential:
Phone: 704-604-5677