Provider Demographics
NPI:1972620623
Name:TOTAL HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:TOTAL HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:YASSEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-416-9995
Mailing Address - Street 1:6315 SPALDING DR
Mailing Address - Street 2:SUITE B110
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092
Mailing Address - Country:US
Mailing Address - Phone:770-416-9995
Mailing Address - Fax:770-416-6777
Practice Address - Street 1:6315 SPALDING DR
Practice Address - Street 2:SUITE B110
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092
Practice Address - Country:US
Practice Address - Phone:770-416-9995
Practice Address - Fax:770-416-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
H44894Medicare UPIN
08BBVFWMedicare ID - Type Unspecified