Provider Demographics
NPI:1992048029
Name:THE TA NETWORK, LLC
Entity type:Organization
Organization Name:THE TA NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PASTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:REV
Authorized Official - Phone:843-229-7413
Mailing Address - Street 1:1646 HARRIS CT
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-1545
Mailing Address - Country:US
Mailing Address - Phone:843-229-7413
Mailing Address - Fax:
Practice Address - Street 1:1646 HARRIS CT
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-1545
Practice Address - Country:US
Practice Address - Phone:843-229-7413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty