Provider Demographics
NPI:1629724083
Name:T & T HEALTHCARE, PLLC
Entity type:Organization
Organization Name:T & T HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TRIPHENA
Authorized Official - Middle Name:CHANEL
Authorized Official - Last Name:SMALLS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:404-313-5009
Mailing Address - Street 1:3945 WOODLAND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-8209
Mailing Address - Country:US
Mailing Address - Phone:980-271-7561
Mailing Address - Fax:
Practice Address - Street 1:3729 SHAMROCK DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3217
Practice Address - Country:US
Practice Address - Phone:980-271-7561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251J00000XAgenciesNursing Care