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General NPI Number Information
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NPI Number | 1043410715
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Entity Type | Organization
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Legal Business Name | TLCBYD&J
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 6 MIMOSA CRES
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City | HAMPTON
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State | VA
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Zip | 23661-2326
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Country | US
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Telephone | 757-329-9497
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Fax | 757-240-4117
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Provider Business Mailing Address
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Address Line | 1206 KECOUGHTAN RD
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City | HAMPTON RD
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State | VA
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Zip | 23661
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Country | US
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Telephone | 757-245-1313
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Fax | 757-240-4117
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JANICE PARKER HOUFF
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Credential |
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Telephone | 757-245-1313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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