Provider Demographics
NPI:1356044853
Name:TIBONG HEALTHCARE INC
Entity type:Organization
Organization Name:TIBONG HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:POLLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NTOH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-714-3107
Mailing Address - Street 1:9414 OLIVE STONE DR
Mailing Address - Street 2:
Mailing Address - City:IOWA COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:77583-1878
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9414 OLIVE STONE DR
Practice Address - Street 2:
Practice Address - City:IOWA COLONY
Practice Address - State:TX
Practice Address - Zip Code:77583-1878
Practice Address - Country:US
Practice Address - Phone:214-714-3107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care