Provider Demographics
NPI:1184995318
Name:TACHIINII NURSING SERVICES, INC.
Entity type:Organization
Organization Name:TACHIINII NURSING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:QUINTAN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:435-220-1051
Mailing Address - Street 1:PO BOX 394
Mailing Address - Street 2:
Mailing Address - City:ROCK POINT
Mailing Address - State:AZ
Mailing Address - Zip Code:86545
Mailing Address - Country:US
Mailing Address - Phone:928-659-4141
Mailing Address - Fax:
Practice Address - Street 1:49314 HIGHWAY US-191
Practice Address - Street 2:
Practice Address - City:ROCK POINT
Practice Address - State:AZ
Practice Address - Zip Code:86545
Practice Address - Country:US
Practice Address - Phone:929-659-4141
Practice Address - Fax:928-659-4299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-19
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT7926802OtherSTATE OF UTAH DIVISION OF CORPORATION AND COMMERCIAL CODE NUMBER