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General NPI Number Information
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NPI Number | 1700936127
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Entity Type | Organization
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Legal Business Name | TBI SERVICES, LLC
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7857 CHESTNUT RIDGE RD
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City | GASPORT
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State | NY
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Zip | 14067-9503
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Country | US
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Telephone | 716-998-1104
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Fax | 866-354-8174
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Provider Business Mailing Address
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Address Line | 7857 CHESTNUT RIDGE RD
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City | GASPORT
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State | NY
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Zip | 14067-9503
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Country | US
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Telephone | 716-998-1104
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Fax | 866-354-8174
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DIANE WEEKS FERNANDEZ
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Credential | MS, CRC
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Telephone | 716-998-1104
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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 | 18557
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License Number State | NY
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