Provider Demographics
NPI:1861853012
Name:TOBOLA HEALTH CARE SERVICES INC.
Entity Type:Organization
Organization Name:TOBOLA HEALTH CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLUYEMI
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:AWODIYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-833-1149
Mailing Address - Street 1:618 NESTING LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-6124
Mailing Address - Country:US
Mailing Address - Phone:302-357-8363
Mailing Address - Fax:
Practice Address - Street 1:618 NESTING LN
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-6124
Practice Address - Country:US
Practice Address - Phone:302-357-8363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities