Provider Demographics
NPI:1316373202
Name:TEEBEE COMMUNITY RESOURCE AND CARE, LLC
Entity Type:Organization
Organization Name:TEEBEE COMMUNITY RESOURCE AND CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BAKER-THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:407-232-4659
Mailing Address - Street 1:108 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-3612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 FOREST AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-3612
Practice Address - Country:US
Practice Address - Phone:407-232-4659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL13000126547251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management