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General NPI Number Information
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NPI Number | 1497007066
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Entity Type | Organization
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Legal Business Name | TOTAL INNOVATIZE
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Dates
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Enumeration Date | 10/08/2012
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Last Update Date | 10/08/2012
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Provider Practice Location Address
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Address Line | 1805 MONTANNA AVE
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City | NORTHEAST
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State | DC
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Zip | 20002
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Country | US
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Telephone | 202-747-3451
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Fax | 187-798-8424
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Provider Business Mailing Address
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Address Line | 1805 MONTANA AVE NE
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City | WASHINGTON
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State | DC
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Zip | 20002-1859
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Country | US
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Telephone | 202-747-3451
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Fax | 187-798-8424
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Authorized Official
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Title or Position | HOME HEALTH AIDE
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Name | TIFFANY M THOMAS
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Credential | HHA
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Telephone | 202-717-3776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | H100082
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License Number State | DC
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