Provider Demographics
NPI:1639835747
Name:T&G LLC
Entity Type:Organization
Organization Name:T&G LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-327-0685
Mailing Address - Street 1:25 HAMPSHIRE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4489
Mailing Address - Country:US
Mailing Address - Phone:978-327-0685
Mailing Address - Fax:
Practice Address - Street 1:727 LAFAYETTE RD STE 6
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:NH
Practice Address - Zip Code:03874-4255
Practice Address - Country:US
Practice Address - Phone:978-327-0685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care