Provider Demographics
NPI:1376142752
Name:TYBLESS HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:TYBLESS HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TOYIN
Authorized Official - Middle Name:BLESSING
Authorized Official - Last Name:BISIRIYU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-902-0813
Mailing Address - Street 1:19330 JORDANS LANDING LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3299
Mailing Address - Country:US
Mailing Address - Phone:832-902-0813
Mailing Address - Fax:
Practice Address - Street 1:19330 JORDANS LANDING LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-3299
Practice Address - Country:US
Practice Address - Phone:832-902-0813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-18
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty