Provider Demographics
NPI:1538466636
Name:TECHOTA LLC
Entity Type:Organization
Organization Name:TECHOTA LLC
Other - Org Name:CV HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:205-562-9615
Mailing Address - Street 1:17035 HIGHWAY 11 N
Mailing Address - Street 2:
Mailing Address - City:VANCE
Mailing Address - State:AL
Mailing Address - Zip Code:35490-2422
Mailing Address - Country:US
Mailing Address - Phone:205-562-9615
Mailing Address - Fax:205-423-6804
Practice Address - Street 1:17035 HIGHWAY 11 N
Practice Address - Street 2:
Practice Address - City:VANCE
Practice Address - State:AL
Practice Address - Zip Code:35490-2422
Practice Address - Country:US
Practice Address - Phone:205-562-9615
Practice Address - Fax:205-423-6804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL017169Medicare Oscar/Certification