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General NPI Number Information
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NPI Number | 1316061534
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Entity Type | Organization
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Legal Business Name | TOM & JERRY MANAGEMENT, LLC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 111 SOUTH CHURCH STREET
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City | HUNTERSVILLE
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State | NC
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Zip | 28078
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Country | US
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Telephone | 704-875-0859
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Fax | 704-948-0763
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Provider Business Mailing Address
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Address Line | PO BOX 686
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City | HUNTERSVILLE
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State | NC
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Zip | 28070-0686
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Country | US
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Telephone | 704-875-0859
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Fax | 704-948-0763
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Authorized Official
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Title or Position | OWNER/MANAGER MEMBER
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Name | JERRY RONALD CHAPMAN
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Credential |
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Telephone | 336-408-8140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | HAL-060-014
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License Number State | NC
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