Provider Demographics
NPI:1659030435
Name:TT&M COMMUNITY SERVICES LLC
Entity type:Organization
Organization Name:TT&M COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TENA
Authorized Official - Middle Name:LINNEESE
Authorized Official - Last Name:ARTISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-228-8400
Mailing Address - Street 1:1285 N KING ST STE 6
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-2233
Mailing Address - Country:US
Mailing Address - Phone:757-964-9565
Mailing Address - Fax:757-964-9566
Practice Address - Street 1:1285 N KING ST STE 6
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-2233
Practice Address - Country:US
Practice Address - Phone:757-964-9565
Practice Address - Fax:757-964-9566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3453Medicaid