Provider Demographics
NPI:1376948935
Name:T.S. DATA LLC
Entity Type:Organization
Organization Name:T.S. DATA LLC
Other - Org Name:FAMILY FIRST MANAGEMENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TREMYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-393-1519
Mailing Address - Street 1:1425 BATTLEFIELD BLVD BOX #3112
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23327-3112
Mailing Address - Country:US
Mailing Address - Phone:757-416-5001
Mailing Address - Fax:877-839-8853
Practice Address - Street 1:ONE COLUMBUS CENTER STE #26
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:757-416-5001
Practice Address - Fax:877-839-8853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA017251B00000X, 251S00000X
VA2014257663-R310500000X, 311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0171535872Medicaid
VA0169290183Medicaid
VA0170389826Medicaid