Provider Demographics
NPI:1033834916
Name:TALLES HOME CARE SERVICE PROVIDER LLC
Entity Type:Organization
Organization Name:TALLES HOME CARE SERVICE PROVIDER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE-CHANTALLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-963-0798
Mailing Address - Street 1:232 WOLFENDEN AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19023-3220
Mailing Address - Country:US
Mailing Address - Phone:484-963-0798
Mailing Address - Fax:
Practice Address - Street 1:232 WOLFENDEN AVE
Practice Address - Street 2:
Practice Address - City:COLLINGDALE
Practice Address - State:PA
Practice Address - Zip Code:19023-3220
Practice Address - Country:US
Practice Address - Phone:484-963-0798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care