Provider Demographics
NPI:1386784858
Name:TIMS HOME CARE AGENCY INC
Entity type:Organization
Organization Name:TIMS HOME CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:DAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-691-1943
Mailing Address - Street 1:814 DALEVIEW PLACE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-4112
Mailing Address - Country:US
Mailing Address - Phone:336-691-1943
Mailing Address - Fax:336-691-7350
Practice Address - Street 1:814 DALEVIEW PL
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-4112
Practice Address - Country:US
Practice Address - Phone:336-691-1943
Practice Address - Fax:336-691-7350
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TIMS HOME CARE AGENCY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-07
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3617251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418395Medicaid
NC6601651Medicaid