Provider Demographics
NPI:1841959038
Name:TSG COMMUNITY SERVICES
Entity type:Organization
Organization Name:TSG COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NADEGE
Authorized Official - Middle Name:
Authorized Official - Last Name:TREVANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-475-8074
Mailing Address - Street 1:11327 BOOTH BAY WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3429
Mailing Address - Country:US
Mailing Address - Phone:301-844-1586
Mailing Address - Fax:
Practice Address - Street 1:11327 BOOTH BAY WAY
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3429
Practice Address - Country:US
Practice Address - Phone:301-844-1586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care