Provider Demographics
NPI:1396977161
Name:LIYA'S HOME CARE LLC
Entity type:Organization
Organization Name:LIYA'S HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:TELKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-215-7204
Mailing Address - Street 1:8068 STRATFORD CIR S
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-3147
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8068 STRATFORD CIR S
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-3147
Practice Address - Country:US
Practice Address - Phone:952-215-7204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care