Provider Demographics
NPI:1396040614
Name:TDMK, LLC
Entity Type:Organization
Organization Name:TDMK, LLC
Other - Org Name:ALL CARE HEALTH SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLESHIEM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:208-473-2717
Mailing Address - Street 1:815 S BRIDGE WAY PL
Mailing Address - Street 2:SUITE 122
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-6006
Mailing Address - Country:US
Mailing Address - Phone:208-473-2717
Mailing Address - Fax:877-890-5617
Practice Address - Street 1:815 S BRIDGE WAY PL
Practice Address - Street 2:SUITE 122
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-6006
Practice Address - Country:US
Practice Address - Phone:208-473-2717
Practice Address - Fax:877-890-5617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDHH-253251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID137121Medicare PIN