Provider Demographics
NPI:1851165674
Name:TIKA HOME CARE LLC.
Entity Type:Organization
Organization Name:TIKA HOME CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:100 PERCENT OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:V
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-497-3713
Mailing Address - Street 1:628 CASSIDY RD
Mailing Address - Street 2:
Mailing Address - City:GASTON
Mailing Address - State:SC
Mailing Address - Zip Code:29053
Mailing Address - Country:US
Mailing Address - Phone:803-497-3713
Mailing Address - Fax:
Practice Address - Street 1:628 CASSIDY RD
Practice Address - Street 2:
Practice Address - City:GASTON
Practice Address - State:SC
Practice Address - Zip Code:29053
Practice Address - Country:US
Practice Address - Phone:803-497-3713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty