Provider Demographics
NPI:1619361557
Name:TAMIKAS HOME HEALTH CARE
Entity Type:Organization
Organization Name:TAMIKAS HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTHCARE PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-639-3891
Mailing Address - Street 1:PO BOX 28102
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-0102
Mailing Address - Country:US
Mailing Address - Phone:870-639-3891
Mailing Address - Fax:
Practice Address - Street 1:6076 PIEDMONT ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-3949
Practice Address - Country:US
Practice Address - Phone:870-639-3891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home