Provider Demographics
NPI: | 1497207187 |
---|---|
Name: | TD INDUSTRIES |
Entity Type: | Organization |
Organization Name: | TD INDUSTRIES |
Other - Org Name: | ELDERS ELITE HOME CARE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | DONALD |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | DAVIS |
Authorized Official - Suffix: | JR |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 949-939-3685 |
Mailing Address - Street 1: | 1 GREEN BRIER CIR |
Mailing Address - Street 2: | |
Mailing Address - City: | COTO DE CAZA |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92679-4175 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 949-939-3685 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 29839 SANTA MARGARITA PKWY |
Practice Address - Street 2: | SUITE 300, OFFICE 8 |
Practice Address - City: | RANCHO SANTA MARGARITA |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92688-3616 |
Practice Address - Country: | US |
Practice Address - Phone: | 949-709-7967 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-10-27 |
Last Update Date: | 2016-10-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 304700092 | 253Z00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 253Z00000X | Agencies | In Home Supportive Care |