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General NPI Number Information
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NPI Number | 1457800708
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Entity Type | Organization
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Legal Business Name | T & T LOVING CARE HOME, INC.
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Dates
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Enumeration Date | 09/28/2016
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Last Update Date | 09/28/2016
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Provider Practice Location Address
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Address Line | 7106 BERRYWOOD LN
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City | JACKSONVILLE
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State | FL
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Zip | 32277-2609
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Country | US
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Telephone | 904-613-2234
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Fax | 904-744-9084
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Provider Business Mailing Address
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Address Line | 7106 BERRYWOOD LN
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City | JACKSONVILLE
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State | FL
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Zip | 32277-2609
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Country | US
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Telephone | 904-613-2234
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Fax | 904-744-9084
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | CAROLYN FAYE BENTLEY
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Credential |
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Telephone | 904-613-2234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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