Provider Demographics
NPI: | 1821307067 |
---|---|
Name: | TIFFCO CARE LLC |
Entity Type: | Organization |
Organization Name: | TIFFCO CARE LLC |
Other - Org Name: | VISITING ANGELS |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | PATRICK |
Authorized Official - Middle Name: | EDWARD |
Authorized Official - Last Name: | KELLEY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 765-848-1411 |
Mailing Address - Street 1: | 1208 S BLOOMINGTON ST |
Mailing Address - Street 2: | SUITE A |
Mailing Address - City: | GREENCASTLE |
Mailing Address - State: | IN |
Mailing Address - Zip Code: | 46135-2269 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 765-848-1411 |
Mailing Address - Fax: | 765-848-1046 |
Practice Address - Street 1: | 1208 S BLOOMINGTON ST |
Practice Address - Street 2: | SUITE A |
Practice Address - City: | GREENCASTLE |
Practice Address - State: | IN |
Practice Address - Zip Code: | 46135-2269 |
Practice Address - Country: | US |
Practice Address - Phone: | 765-848-1411 |
Practice Address - Fax: | 765-848-1046 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-10-06 |
Last Update Date: | 2010-10-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IN | 100123411 | 251E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |