Provider Demographics
NPI:1942894217
Name:TATO HEALTHCARE AGENCY
Entity Type:Organization
Organization Name:TATO HEALTHCARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-275-6493
Mailing Address - Street 1:12230 W FLANAGAN ST
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-8122
Mailing Address - Country:US
Mailing Address - Phone:480-560-1930
Mailing Address - Fax:
Practice Address - Street 1:12230 W FLANAGAN ST
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-8122
Practice Address - Country:US
Practice Address - Phone:480-560-1930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251F00000XAgenciesHome Infusion
No253J00000XAgenciesFoster Care Agency
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No315D00000XNursing & Custodial Care FacilitiesHospice, InpatientGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty