Provider Demographics
NPI:1750826384
Name:TIERNO CARE HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:TIERNO CARE HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:NGWA
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-408-1615
Mailing Address - Street 1:2503 ALLISON ST
Mailing Address - Street 2:2
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1254
Mailing Address - Country:US
Mailing Address - Phone:301-658-8847
Mailing Address - Fax:
Practice Address - Street 1:1101 L ST NW
Practice Address - Street 2:204
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4031
Practice Address - Country:US
Practice Address - Phone:202-808-2362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC12631251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health