Provider Demographics
NPI:1285025536
Name:TY'S DAYCARE & PRE K CENTER INC.
Entity Type:Organization
Organization Name:TY'S DAYCARE & PRE K CENTER INC.
Other - Org Name:TY'S HEALTHY HEALERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TYTEOUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-315-4958
Mailing Address - Street 1:1137 E 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16503-2306
Mailing Address - Country:US
Mailing Address - Phone:814-315-4958
Mailing Address - Fax:814-878-0032
Practice Address - Street 1:725 FRENCH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1207
Practice Address - Country:US
Practice Address - Phone:814-315-4958
Practice Address - Fax:814-878-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA27113601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2711Medicare PIN