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General NPI Number Information
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NPI Number | 1497207187
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Entity Type | Organization
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Legal Business Name | TD INDUSTRIES
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Dates
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Enumeration Date | 10/27/2016
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Last Update Date | 10/27/2016
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Provider Practice Location Address
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Address Line | 29839 SANTA MARGARITA PKWY SUITE 300, OFFICE 8
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-3616
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Country | US
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Telephone | 949-709-7967
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Fax |
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Provider Business Mailing Address
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Address Line | 1 GREEN BRIER CIR
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City | COTO DE CAZA
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State | CA
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Zip | 92679-4175
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Country | US
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Telephone | 949-939-3685
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DONALD DAVIS JR.
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Credential |
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Telephone | 949-939-3685
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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 | 304700092
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License Number State | CA
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