Provider Demographics
NPI:1134565161
Name:MATERELLI HOME HEALTH SERVICES INC.
Entity type:Organization
Organization Name:MATERELLI HOME HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESITA
Authorized Official - Middle Name:MAGBANUA
Authorized Official - Last Name:TAYENGCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-886-9899
Mailing Address - Street 1:1211 N SHARTEL AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-2425
Mailing Address - Country:US
Mailing Address - Phone:405-236-4700
Mailing Address - Fax:405-236-4701
Practice Address - Street 1:1211 N SHARTEL AVE STE 405
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-2425
Practice Address - Country:US
Practice Address - Phone:405-236-4700
Practice Address - Fax:405-236-4701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8010251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health