Provider Demographics
NPI:1568753085
Name:T J CARE LLC
Entity Type:Organization
Organization Name:T J CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:DEVONE
Authorized Official - Last Name:ALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:MA/CARE GIVER
Authorized Official - Phone:678-616-5105
Mailing Address - Street 1:473 TOWNSEND BND
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7989
Mailing Address - Country:US
Mailing Address - Phone:678-616-1402
Mailing Address - Fax:
Practice Address - Street 1:473 TOWNSEND BND
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7989
Practice Address - Country:US
Practice Address - Phone:678-616-1402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health