Provider Demographics
NPI:1972738516
Name:TIKOR COMMUNITY & HUMAN SERVICES, INC.
Entity Type:Organization
Organization Name:TIKOR COMMUNITY & HUMAN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SAFFA-WUYA
Authorized Official - Suffix:SR
Authorized Official - Credentials:MBA
Authorized Official - Phone:703-596-4830
Mailing Address - Street 1:7810 NEWINGTON WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-2235
Mailing Address - Country:US
Mailing Address - Phone:703-596-4830
Mailing Address - Fax:703-652-7737
Practice Address - Street 1:7810 NEWINGTON WOODS DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22153-2235
Practice Address - Country:US
Practice Address - Phone:703-596-4830
Practice Address - Fax:703-652-7737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1245-01-001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1245OtherDMHMRSAS - A INTELLECTUAL DISABILITY RESIDENTIAL GROUP HOME SERVICE FOR ADULTS