=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639835747
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | T&G LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/12/2021
-----------------------------------------------------
Last Update Date | 01/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 90 STILES RD STE 201
-----------------------------------------------------
City | SALEM
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03079-4884
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-327-0685
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16 OAK RIDGE AVE APT 8
-----------------------------------------------------
City | SALEM
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03079-4493
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-327-0685
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. TERESIAN KIMANI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 978-327-0685
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------