Provider Demographics
NPI:1477236537
Name:T&D GROUP HOME LLC
Entity Type:Organization
Organization Name:T&D GROUP HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TAJ
Authorized Official - Middle Name:T
Authorized Official - Last Name:TIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-345-8117
Mailing Address - Street 1:2111 SPRING AVE SW
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-5717
Mailing Address - Country:US
Mailing Address - Phone:256-345-8117
Mailing Address - Fax:
Practice Address - Street 1:2111 SPRING AVE SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-5717
Practice Address - Country:US
Practice Address - Phone:256-345-8117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities