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General NPI Number Information
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NPI Number | 1487960555
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Entity Type | Organization
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Legal Business Name | TJM HOME HEALTH CARE
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Dates
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Enumeration Date | 08/26/2010
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 333 17TH ST STE 2R-3
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City | VERO BEACH
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State | FL
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Zip | 32960-5670
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Country | US
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Telephone | 772-257-0442
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Fax |
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Provider Business Mailing Address
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Address Line | 333 17TH ST STE 2R-3
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City | VERO BEACH
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State | FL
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Zip | 32960-5670
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTOR
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Name | MR. THOMAS J MICHAELS
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Credential |
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Telephone | 772-257-0442
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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 | 299992627
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License Number State | FL
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