Healthcare Provider Details

I. General information

NPI: 1730069642
Provider Name (Legal Business Name): TPRIME SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 OLD WOODLAND DR
CHESAPEAKE VA
23321-1968
US

IV. Provider business mailing address

4444 OLD WOODLAND DR
CHESAPEAKE VA
23321-1968
US

V. Phone/Fax

Practice location:
  • Phone: 757-738-6750
  • Fax:
Mailing address:
  • Phone: 757-738-6750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: EBELE T IZUEGBUNAM
Title or Position: PROGRAM MANAGER
Credential:
Phone: 757-738-6750