Provider Demographics
NPI:1578894788
Name:TIDEWELL HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:TIDEWELL HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAISTO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MA, MS
Authorized Official - Phone:941-552-7500
Mailing Address - Street 1:3355 26TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-3607
Mailing Address - Country:US
Mailing Address - Phone:941-782-4900
Mailing Address - Fax:941-739-8937
Practice Address - Street 1:3355 26TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-3607
Practice Address - Country:US
Practice Address - Phone:941-782-4900
Practice Address - Fax:941-739-8937
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TIDEWELL HEALTH SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-28
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health