Provider Demographics
NPI:1376854562
Name:TDS HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:TDS HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:LOVETTE
Authorized Official - Last Name:MINGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-449-5182
Mailing Address - Street 1:PO BOX 433
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-0433
Mailing Address - Country:US
Mailing Address - Phone:980-337-1281
Mailing Address - Fax:
Practice Address - Street 1:5513 MONROE RD STE 206
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-5503
Practice Address - Country:US
Practice Address - Phone:980-337-1281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care