Provider Demographics
NPI:1962076232
Name:TMT INITIATIVES HOME CARE AGENCY
Entity type:Organization
Organization Name:TMT INITIATIVES HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GLOWDEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMBROSE-JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-866-9272
Mailing Address - Street 1:4207 MADISON DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-8951
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4207 MADISON DR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8951
Practice Address - Country:US
Practice Address - Phone:484-866-9272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA