Provider Demographics
NPI:1033827365
Name:TIDY HOME & HEALTH CLEANING LLC
Entity Type:Organization
Organization Name:TIDY HOME & HEALTH CLEANING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PA'SHUN
Authorized Official - Middle Name:
Authorized Official - Last Name:MINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-915-0680
Mailing Address - Street 1:1511 BRIDGE ST NW APT 360
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-1706
Mailing Address - Country:US
Mailing Address - Phone:616-915-0680
Mailing Address - Fax:
Practice Address - Street 1:1511 BRIDGE ST NW APT 360
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-1706
Practice Address - Country:US
Practice Address - Phone:616-915-0680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty