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General NPI Number Information
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NPI Number | 1710599873
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Entity Type | Organization
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Legal Business Name | TINAS LOVE AND CARE INC
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 165 CHOATE ST
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City | PORTSMOUTH
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State | VA
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Zip | 23707-4567
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Country | US
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Telephone | 757-938-5396
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Fax |
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Provider Business Mailing Address
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Address Line | 1751 CHURCH ST STE A
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City | NORFOLK
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State | VA
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Zip | 23504-2313
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Country | US
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Telephone | 757-938-5396
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Fax | 757-628-1022
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Authorized Official
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Title or Position | CO-OWNER
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Name | TIERRA MON'E WALKER
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Credential |
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Telephone | 443-804-4252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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