Provider Demographics
NPI:1780057596
Name:TIFFANY'S COMPASSIONATE CARE LLC
Entity type:Organization
Organization Name:TIFFANY'S COMPASSIONATE CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:BRIANA
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:734-657-5117
Mailing Address - Street 1:534 WESTBROOK
Mailing Address - Street 2:
Mailing Address - City:WHITMORE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48189-8212
Mailing Address - Country:US
Mailing Address - Phone:734-730-4175
Mailing Address - Fax:
Practice Address - Street 1:534 WESTBROOK
Practice Address - Street 2:
Practice Address - City:WHITMORE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48189-8212
Practice Address - Country:US
Practice Address - Phone:734-730-4175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI230007522681002251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health