Provider Demographics
NPI:1922695246
Name:TEAM US TOGETHERNESS LOVE CONQUERS ALL
Entity Type:Organization
Organization Name:TEAM US TOGETHERNESS LOVE CONQUERS ALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TOSHA
Authorized Official - Middle Name:TLETTE
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-589-7121
Mailing Address - Street 1:5353 BIRCHBEND CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-2801
Mailing Address - Country:US
Mailing Address - Phone:336-589-7121
Mailing Address - Fax:
Practice Address - Street 1:5353 BIRCHBEND CT
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2801
Practice Address - Country:US
Practice Address - Phone:336-589-7121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0115856Medicaid