Provider Demographics
NPI: | 1952507766 |
---|---|
Name: | TIFFANY CARE CENTERS, INC |
Entity Type: | Organization |
Organization Name: | TIFFANY CARE CENTERS, INC |
Other - Org Name: | TIFFANY IN HOME SERVICES |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | PAULA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MILLER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 660-442-3128 |
Mailing Address - Street 1: | 1105 STATE ST. |
Mailing Address - Street 2: | PO BOX 308 |
Mailing Address - City: | MOUND CITY |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 64470-0308 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 660-442-3128 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1105 STATE ST. |
Practice Address - Street 2: | |
Practice Address - City: | MOUND CITY |
Practice Address - State: | MO |
Practice Address - Zip Code: | 64470-0308 |
Practice Address - Country: | US |
Practice Address - Phone: | 660-442-3128 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-06-27 |
Last Update Date: | 2007-08-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | Group - Multi-Specialty | |
No | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Multi-Specialty | |
No | 372500000X | Nursing Service Related Providers | Chore Provider | Group - Multi-Specialty | |
No | 372600000X | Nursing Service Related Providers | Adult Companion | Group - Multi-Specialty | |
No | 373H00000X | Nursing Service Related Providers | Day Training/Habilitation Specialist | Group - Multi-Specialty | |
No | 374700000X | Nursing Service Related Providers | Technician | Group - Multi-Specialty | |
No | 3747A0650X | Nursing Service Related Providers | Technician | Attendant Care Provider | Group - Multi-Specialty |
No | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant | Group - Multi-Specialty |
No | 374T00000X | Nursing Service Related Providers | Religious Nonmedical Nursing Personnel | Group - Multi-Specialty | |
No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty | |
No | 376G00000X | Nursing Service Related Providers | Nursing Home Administrator | Group - Multi-Specialty | |
No | 376J00000X | Nursing Service Related Providers | Homemaker | Group - Multi-Specialty | |
No | 376K00000X | Nursing Service Related Providers | Nurse's Aide | Group - Multi-Specialty |