Provider Demographics
NPI:1750627667
Name:TSR GROUP HOME LLC
Entity type:Organization
Organization Name:TSR GROUP HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RASHONDA
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-990-0661
Mailing Address - Street 1:3010 COTTON PL SW
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-1427
Mailing Address - Country:US
Mailing Address - Phone:256-990-0661
Mailing Address - Fax:256-686-2726
Practice Address - Street 1:3010 COTTON PL SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-1427
Practice Address - Country:US
Practice Address - Phone:256-990-0661
Practice Address - Fax:256-686-2726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health