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General NPI Number Information
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NPI Number | 1992245138
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Entity Type | Organization
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Legal Business Name | T & B BUSINESS, LLC
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Dates
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Enumeration Date | 03/07/2017
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 447 BROAD ST
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City | MERIDEN
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State | CT
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Zip | 06450-5841
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Country | US
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Telephone | 203-935-6673
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Fax | 203-235-5005
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Provider Business Mailing Address
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Address Line | 447 BROAD ST
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City | MERIDEN
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State | CT
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Zip | 06450-5841
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Country | US
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Telephone | 203-935-6673
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Fax | 203-235-5005
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRYANT TOBY FRIERSON
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Credential |
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Telephone | 203-935-6673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 48476212-000
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License Number State | CT
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