| Organization Name: | TIFT COUNTY BOARD OF HEALTH D/B/A DIVERSIFIED ENTERPRISES |
| NPI Number: | 1033404710 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THERESA DURDEN (WEB PORTAL MANAGER) |
| Mailing Address: | 192 Virginia Ave S Suite 100 Tifton |
| State: | GA US |
| Postal Code: | 317948074 |
| Phone Number: | 2293863122 |
| Fax Number: | 2293867156 |
| NPI Enumeration Date: | 06/10/2011 |
| NPI Last Update Date: | 06/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |