Provider Demographics
NPI:1114628757
Name:TAMAY HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:TAMAY HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:AYEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-564-4167
Mailing Address - Street 1:14513 OXBOW CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:MN
Mailing Address - Zip Code:55327-4416
Mailing Address - Country:US
Mailing Address - Phone:952-564-4167
Mailing Address - Fax:
Practice Address - Street 1:5824 42ND AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55422-1634
Practice Address - Country:US
Practice Address - Phone:952-564-4167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility