Provider Demographics
NPI:1093967416
Name:IT'S ABOUT TIME, INC
Entity Type:Organization
Organization Name:IT'S ABOUT TIME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MITZI
Authorized Official - Middle Name:JAYNE
Authorized Official - Last Name:TUCK
Authorized Official - Suffix:
Authorized Official - Credentials:BSW QMRP
Authorized Official - Phone:540-206-2367
Mailing Address - Street 1:1316 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4953
Mailing Address - Country:US
Mailing Address - Phone:540-206-2367
Mailing Address - Fax:540-226-7640
Practice Address - Street 1:1316 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4953
Practice Address - Country:US
Practice Address - Phone:540-206-2367
Practice Address - Fax:540-226-7640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1113-02-006251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services