Provider Demographics
NPI:1306416839
Name:TIER 1 HOME HEALTH LLC
Entity Type:Organization
Organization Name:TIER 1 HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LASANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-604-0157
Mailing Address - Street 1:5759 WATERSIDE DR APT 203
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-9649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5759 WATERSIDE DR APT 203
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-9649
Practice Address - Country:US
Practice Address - Phone:863-604-0157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty