Provider Demographics
NPI:1821332198
Name:T. WILLIAMS ENTERPRISES CORP
Entity Type:Organization
Organization Name:T. WILLIAMS ENTERPRISES CORP
Other - Org Name:SERENITY PERSONAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TARSHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-478-7336
Mailing Address - Street 1:1021 EDEN WAY N
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2776
Mailing Address - Country:US
Mailing Address - Phone:757-424-9800
Mailing Address - Fax:757-424-9801
Practice Address - Street 1:1021 EDEN WAY N
Practice Address - Street 2:SUITE 120
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2776
Practice Address - Country:US
Practice Address - Phone:757-424-9800
Practice Address - Fax:757-424-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WC2100X, 251E00000X, 253Z00000X
VAHCO-189003747P1801X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No163WC2100XNursing Service ProvidersRegistered NurseContinence CareGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1821332198Medicaid