Provider Demographics
NPI:1962767574
Name:TD HOME CARE SERVICES,LLC
Entity type:Organization
Organization Name:TD HOME CARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLESSING
Authorized Official - Middle Name:ENO
Authorized Official - Last Name:KAYODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-771-8297
Mailing Address - Street 1:21422 DEEPWOOD TER
Mailing Address - Street 2:411
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4090
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21422 DEEPWOOD TER
Practice Address - Street 2:411
Practice Address - City:BROADLANDS
Practice Address - State:VA
Practice Address - Zip Code:20148-4090
Practice Address - Country:US
Practice Address - Phone:703-771-8297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care