Healthcare Provider Details

I. General information

NPI: 1306685433
Provider Name (Legal Business Name): T5 CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 ROYALTY DR
ETNA OH
43062-8273
US

IV. Provider business mailing address

119 ROYALTY DR
ETNA OH
43062-8273
US

V. Phone/Fax

Practice location:
  • Phone: 614-735-8803
  • Fax:
Mailing address:
  • Phone: 614-735-8803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: TERENCE HARRIS
Title or Position: PRESIDENT
Credential:
Phone: 614-735-8803