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Contact Information

TIFT COUNTY BOARD OF HEALTH D/B/A DIVERSIFIED ENTERPRISES
192 S. VIRGINIA AVE.
SUITE 100
TIFTON, GA31794
 Phone: 229-386-3122
 Fax: 229-386-7156
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

In Home Supportive Care

253Z00000X
Indicates primary specialty

NPI Profile & details for TIFT COUNTY BOARD OF HEALTH D/B/A DIVERSIFIED ENTERPRISES

NPI # 1902191653
LBN Legal business name TIFT COUNTY BOARD OF HEALTH D/B/A DIVERSIFIED ENTERPRISES
Authorized official THERESA DURDEN - (WEB PORTAL MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/10/2011
Last updated 06/10/2011 - About 15 years ago
Identifiers
GA Medicaid 000609771AT
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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