Provider Demographics
NPI:1952829079
Name:THOMASSON LAND HOLDINGS, LLC
Entity Type:Organization
Organization Name:THOMASSON LAND HOLDINGS, LLC
Other - Org Name:ALLHEART CASE MANAGEMENT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:THOMASSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-416-0105
Mailing Address - Street 1:PO BOX 1642
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:MS
Mailing Address - Zip Code:39350-1642
Mailing Address - Country:US
Mailing Address - Phone:601-416-3828
Mailing Address - Fax:601-656-3896
Practice Address - Street 1:1007 SAINT FRANCIS DR
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:MS
Practice Address - Zip Code:39350-2029
Practice Address - Country:US
Practice Address - Phone:601-416-3828
Practice Address - Fax:601-656-3896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-08
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00000OtherNOT APPLICABLE