Healthcare Provider Details

I. General information

NPI: 1902136393
Provider Name (Legal Business Name): TJS HOME CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2010
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3436 BEAMAN OLD CREEK RD
SNOW HILL NC
28580-8308
US

IV. Provider business mailing address

3436 BEAMAN OLD CREEK RD
SNOW HILL NC
28580-8308
US

V. Phone/Fax

Practice location:
  • Phone: 252-747-4304
  • Fax: 252-747-5029
Mailing address:
  • Phone: 252-747-4304
  • Fax: 252-747-5029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: THELMA R JOHNSON
Title or Position: DIRECTOR
Credential:
Phone: 252-747-4304