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General NPI Number Information
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NPI Number | 1255806907
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Entity Type | Organization
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Legal Business Name | TINAS WORLD OF LOVE
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Dates
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Enumeration Date | 10/09/2018
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Last Update Date | 10/09/2018
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Provider Practice Location Address
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Address Line | 1751 CHURCH ST # C
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City | NORFOLK
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State | VA
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Zip | 23504-2313
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Country | US
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Telephone | 757-500-4306
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Fax | 757-628-1022
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Provider Business Mailing Address
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Address Line | 1751 CHURCH ST # C
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City | NORFOLK
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State | VA
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Zip | 23504-2313
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Country | US
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Telephone | 757-500-4306
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Fax | 757-628-1022
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. VERLEAN GREENE
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Credential |
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Telephone | 757-500-4306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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