Provider Demographics
NPI:1205410586
Name:TINA HOUSE OF HEALING HOME CARE
Entity type:Organization
Organization Name:TINA HOUSE OF HEALING HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-652-0713
Mailing Address - Street 1:26 DAHLIA CT S
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:34446-5533
Mailing Address - Country:US
Mailing Address - Phone:352-652-0713
Mailing Address - Fax:
Practice Address - Street 1:26 DAHLIA CT S
Practice Address - Street 2:
Practice Address - City:HOMOSASSA
Practice Address - State:FL
Practice Address - Zip Code:34446-5533
Practice Address - Country:US
Practice Address - Phone:352-652-0713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty