Provider Demographics
NPI:1215190780
Name:T & M HOME CARE
Entity Type:Organization
Organization Name:T & M HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JATAVIA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-207-2169
Mailing Address - Street 1:1993B E HUDSON BLVD # B
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-6601
Mailing Address - Country:US
Mailing Address - Phone:803-207-2169
Mailing Address - Fax:
Practice Address - Street 1:1993B E HUDSON BLVD # B
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-6601
Practice Address - Country:US
Practice Address - Phone:803-207-2169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINA TOTAL CARE SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-05
Last Update Date:2008-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC311ZA0620X311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home