Provider Demographics
NPI:1003927377
Name:TC HOME HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:TC HOME HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:KNUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-823-5457
Mailing Address - Street 1:11117 WEST OKEECHOBEE ROAD
Mailing Address - Street 2:SUITE 133
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018
Mailing Address - Country:US
Mailing Address - Phone:305-823-5457
Mailing Address - Fax:305-823-5459
Practice Address - Street 1:11117 WEST OKEECHOBEE ROAD
Practice Address - Street 2:SUITE 133
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018
Practice Address - Country:US
Practice Address - Phone:305-823-5457
Practice Address - Fax:305-823-5459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108186Medicare ID - Type Unspecified