Provider Demographics
NPI:1194908558
Name:TIAND
Entity type:Organization
Organization Name:TIAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:EXUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-701-2074
Mailing Address - Street 1:317 JACKSON PARK RD
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-3559
Mailing Address - Country:US
Mailing Address - Phone:704-701-2074
Mailing Address - Fax:704-855-7583
Practice Address - Street 1:317 JACKSON PARK RD
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-3559
Practice Address - Country:US
Practice Address - Phone:704-701-2074
Practice Address - Fax:704-855-7583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-08
Last Update Date:2007-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management