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General NPI Number Information
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NPI Number | 1952166829
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Entity Type | Organization
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Legal Business Name | T MAG ELDER CARE LLC
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Dates
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Enumeration Date | 02/19/2024
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 948 ARMSTRONG RD SE
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City | PALM BAY
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State | FL
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Zip | 32909-4511
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Country | US
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Telephone | 347-515-4310
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Fax |
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Provider Business Mailing Address
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Address Line | 948 ARMSTRONG RD SE
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City | PALM BAY
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State | FL
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Zip | 32909-4511
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Country | US
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Telephone | 347-515-4310
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANTOINETTE KING
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Credential |
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Telephone | 347-515-4310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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